Memorial photo …….………………………Date received…...…..………………………….

MEMORIAL APPLICATION Post mem check………………………………

Please complete this application form and return to the Cemeteries Office for approval at

Tamworth Borough Council Marmion House Lichfield StreetTamworth Staffordshire B79 7BZ

Tel Tamworth (01827) 709343 Fax: Tamworth (01827) 709434 Email:

Stonemason’s Contact Details(To be completed by the stonemason)
Telephone No. Email:
Payment enclosed / Amount / Please send Invoice / No charge
Cheque No
Permission is requested to / Erect a new memorial / Carry out work on an existing memorial
Please give size and method of fixing as required for new memorials
Make an amendment / Clean and renovate / Refix

In

Amington
Cemetery / Glascote
Cemetery / Wigginton Road
Cemetery / Wilnecote New
Cemetery / Wilnecote Old
Cemetery
DECEASED / GRAVE
NUMBER

MEMORIAL DETAILS

Material to be used / Colour of lettering

Please give maximum overall size of memorial in inches please

Length / Height / Width / Depth / FEE / £ P
Headstone including Base
Max height 48” (1219mm)
Max width 30” (762mm)
Tablet Footstone Vase / FEE
Kerbstone without landings
Max length 84” (2133mm)
Max width 36” (914mm) / FEE
Size of landings /foundationsfor kerbs
Max length 87” 210mm)
Max width 39” (990mm)
Type of finish in centre of kerbs. Please tick each appropriate box / solid concrete slabs chippings – colour ……………..………….
soil other (please state) ……………………………………………….
Additional Inscription /Refix
(Please attach details) / Book Headstone Kerbset
Vase Footstone Tablet / FEE
Non-Borough / (DOUBLE FEES) / FEE
Date of last interment (office use) / To locate & mark grave (office use) / TOTAL FEES TO PAY
CHANGES TO ORIGINAL APPLICATION - Any changes made to the memorial and/or inscription after approval has been given must be telephoned or emailed through to this office immediately. Failure to do so could result in the application being delayed or rejected.

**PLEASE ENSURE THAT THE GRAVE NUMBER IS INSCRIBEDON THE BASE AT THE REAR OF THE MEMORIAL - NOT LESS THAN ½” (12MM) HIGH AND NOT MORE THAN 1” (25MM) HIGH.

…………………………………………………………………………………………………......

APPLICANT/GRAVE OWNER(please complete 1 to 6)

1)Applicants Name & Address………………………………………………………………………

…………………………………………………………….Telephone No……………………………………

2)Name of Registered Grave Owner(s)…………………………………………………

Please check with the cemeteries office if the Deed is not in the name of the applicant 3) Owner alive Owner deceased

4) My stonemason has advised me about insuring my memorial

5) I understand that it is my responsibility to ensure that this memorial is maintained in a clean and safe condition and that Tamworth Borough Council will carry out safety tests on my memorial as required of them by current Health and Safety guidelines.

6)Signature ofApplicant/Grave Owner(s)(please delete as appropriate)

……………………………..…………………………………………Date…………………

NB: If the registered owner is alive then he/she is required to sign this form. In the case of joint owners both should sign.

***********************************************************************************************

Signature of Stonemason…………………………………………….Date………….…

Please Print Name……………………………………….Job Title……………………..

PLEASE NOTIFY THE CEMETERY OFFICE BY PHONE, FAX OR EMAIL 24 HOURS BEFORE YOUR STONEMASON INTENDES TO WORK ON A MEMORIAL IN OUR CEMETERIES

Updated 22/06/16