*APPLICATION TO ERECT/REPLACE A MEMORIAL or ADD AN INSCRIPTION
*Delete as applicable
CEMETERY: CERTIFICATE NO:
NAME OF DECEASED: LAIR NO : SECTION:
THE LAIR NUMBER & SECTION “M U S T” BE INSCRIBED ON THE BOTTOM LEFT
HAND SIDE OF THE MEMORIAL IN NOT MORE THAN ONE INCH (1”) LETTERING.
FULL DRAWING/PHOTOGRAPH OF PROPOSED
PROPOSED INSCRIPTION MEMORIAL WITH ALL RELEVANT DIMENSIONS
Name & Address:
Telephone No: Your Order Ref:
I have been instructed to carry out the above work in accordance with the Rules & Regulations for the
Management of Renfrewshire Council Cemeteries. I agree to be responsible and to pay for any damage
to Council property or to surrounding memorials, etc. caused by myself or any person employed by me.
I agree to remove all unused materials and rubbish and to leave the area in a tidy condition.
To be completed by the Rightful Owner of the exclusive RIGHT OF BURIAL (or their Executor, or Next-of-Kin)
I hereby apply for permission to erect and place a memorial as defined above, subject to the
Management Rules for the Council’s cemeteries. I have instructed the above-named Contractor to carry
out the work.
Signature of Applicant: Name of Applicant:
Address of Applicant: Date:
Relationship of Applicant to Deceased/Lairholder
Data protection law changes on 25 May 2018. For more information on how the Council handles your personal details,
OFFICE USE ONLY:
Rec. Date: Cemetery Notified & Permit Sent: Passed by:
Environment & Infrastructure, Renfrewshire House, Cotton Street, Paisley, PA1 1BR
CEMETERIES OFFICE: Tel: 0141-618-7535 / 0141-618-7508 Fax: 0141-618-7501