Notice of Internment

Notice of interment for Millbrook Cemetery

Details of the Deceased

Full name of the deceased(Required)
(Christian name or names and surname of the person to be buried)
(e.g. profession, tradesman - if under 18 please provide the name of the parents).
(if in years, last birthday)
Last Residence(Required)
(address where last resided)
Next of Kin Name(Required)
Next of Kin Address(Required)
Address Where Death Occurred(Required)
DD slash MM slash YYYY

Funeral Information

DD slash MM slash YYYY
Time the Funeral will arrive at the Cemetery(Required)
:
Name of the Minister Intended to Officiate
(if appropriate)

Grave Information

If the grave is already purchased state the number of the grave, grant reference and date purchased.
DD slash MM slash YYYY

Funeral Director

Name of Funeral Director
(if applicable)
Address of Funeral Director
(if applicable)

Confirmation

Processing this data is necessary for compliance with a legal obligation under the Local Authorities Cemeteries Order Act 1977.
Declaration of Information(Required)
Name of Signee(Required)
This field is for validation purposes and should be left unchanged.