APPLICATION FOR THE RESERVATION OF A GRAVESPACE/CREMATION PLOT

When completed please return to:

M Allanson Diocesan Registrar, 8 & 9 the Quadrant, Coventry, CV1 2EG (telephone 024 76227331)

with the Faculty Fee (see note 9 below).

NAME OF PARISH & CHURCH IN WHICH SPACE TO BE RESERVED (Please complete)

……………………………………………………………………..

  1. Please supply the FULL NAME,……………………………………………………..

address and occupation of the Petitioner and……………………………………………………..

state whether a parishioner or non-parishioner.……………………………………………………..

  1. Please supply the full name of the person……………………………………………………..

in the adjoining space to be reserved with date of burial:……………………………………………………..

  1. What relation if any is the Petitioner to the

person in the space adjoining the one to be reserved?……………………………………………………..

  1. Is the space which is proposed to have reserved

an ordinary earth grave, brick grave, vault or cremation plot?……………………………………………

  1. Who is to be buried in the space to be reserved?……………………………………………………...

(Please give FULL NAMES)………………………………………………………

……………………………………………………...

………………………………………………………

  1. Please give the exact measurements of the space to

be reserved and the grave/plot number:………………………………………………………

  1. A sketched plan of the churchyard MUST BE SUPPLIED with this form showing the position in relation to the church of the space/plot to be reserved and having a North pointer thereon
  1. Attached to this form is a Certificate of Consent which must be completed by the Incumbent and Churchwardens stating that the space can be reserved without detriment to the rights of the Parishioners, having regard to the yearly number of burials and spaces available for burial. This must be returned to the Diocesan Registry with the application form. It also gives the Incumbent's consent in writing.
  1. The faculty fee (from1st January 2018) is £293.80and a cheque payable to ROTHERHAM & CO must accompany the application form. PLEASE NOTE: this fee increases annually so if you have been given this form by the Incumbent or Churchwardens please ensure the fee shown is the current fee.
  1. By suggestion of the Chancellor a donation is also payable DIRECTLY TO THE PCCas follows:

For Parishioners

The Incumbent £50andthe Churchyard Fund of the PCC £50 Total £100

For Non-Parishioners

The Incumbent £100andthe Churchyard Fund of the PCC £100 Total £200

Please note: these fees are in addition to the statutory fee shown at (9).

Signed …………………………………………………………………………………...(Petitioner(s))

Dated …………………………………………………………………………………...

Contact telephone number: …………………………………………………………….

CERTIFICATE OF CONSENT FOR THE RESERVATION OF A GRAVESPACE/CREMATION PLOT

I, ………………………………………………………………………………………….

being the Incumbent (or Rural Dean in the case of an interregnum) of the Parish of:

…………………………………………………………………………………………….

in the Diocese of Coventry HEREBY GIVE MY CONSENT to the reservation and appropriation of a GRAVESPACE/CREMATION PLOT (please delete as appropriate) in the churchyard of:

…………………………………………………………………………………………….

for the use of: (please state full names and addresses of those intending to be buried in the space reserved)

……………………………………………………………………………………………

……………………………………………………………………………………………

……………………………………………………………………………………………

……………………………………………………………………………………………

Signed ………………………………………………………

Dated ………………………………………………………

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WE, the undersigned being the Incumbent and Churchwardens of the Parish of:

……………………………………………………………………………………………

in the Diocese of Coventry DO HEREBY CERTIFY that in our opinion having regard to the average yearly number of burials in the Churchyard of:

…………………………………………………………………………………………...

aforesaid the granting of a Faculty to the aforementioned petitioners will not be detrimental to the rights of the Parishioners.

DATED:

…………………………………………………. Churchwardens (full names)

………………………………………………….

…………………………………………………. Incumbent (or Rural Dean)