Renfrewshire Council Environment & Infrastructure
INTERMENT CONFIRMATION - Cemetery
I:\Cemetery\WordPro\MasterForms\Interment Confirmation.lwp
This notice confirms interment details are received by Renfrewshire Council Cemeteries Office. This
notice must be forwarded to the Cemeteries Office prior to the interment taking place. This form should be
accompanied by the “Authority to Open Lair” form duly signed.
Data protection law changes on 25 May 2018. For more information on how the Council handles your personal details, please read
the Privacy Policy on http://www.renfrewshire.gov.uk/privacypolicy
SURNAME :
CHRISTIAN :
NAME(s)
Maiden Surname:
MARITAL STATUS AT TIME OF DEATH
Single/Married/Widowed/Separated/ Divorced
Delete as neccessary
Spouses Name:
(maiden name)
Permanent Address at
Time of Death:
Description of Lair
New Lair / Reopening
(Delete as appropriate)
Lair No:
Section: Class:
Certificate No:
Coffin / Cremated Remains
Coffin Size: (outside dimension inc. handles)
L x W x D
If REOPENING indicate Name and
Address of Lairholder (as
recorded in Ground Register) or
name and date of the last burial.
Lairholder’s Name:
Address:
Relationship of DECEASED to the
Lairholder (as indicated in the
Ground Register)
e.g. Self / Husband / Wife / Son / Daughter / etc
If NEW LAIR is requested - full
name and address of proposed
owner (married female Maiden
Surname is also required)
Name:
(Maiden Surname):
Address:
Post Code
FUNERAL DIRECTOR
Name and Address
Member of staff making arrangements:
Undertaker:
Address:
Post Code:
Tel. No:
Your Ref:
RENFREWSHIRE COUNCIL
RESPECTFUL FUNERAL
SERVICE PACKAGE
YES / NO
Environment & Infrastructure, Renfrewshire House, Cotton Street, Paisley, PA1 1UG
CEMETERIES OFFICE Tel: 0300 300 0380 Fax: 0141 618 7501 Email: p-c.es@renfrewshire.gov.uk
