APPENDIX B: Request for Marker Installation
(For a printed copy of this Appendix B, please download and print this pdf document.)
Dunbarton-Fairport United Church
1066 Dunbarton Road
Pickering, ON L1V 1G8
905-473-5571
Note that the appropriate payment of the Care and Maintenance Fund (in relation to the size of the marker) as set out in the Cemeteries Act (Revised) must accompany the delivery of the marker.
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Monument Company
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Name
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Address
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Phone #
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Contact Name
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Interment Rights Holder
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Name
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Address
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Phone #
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Requested Installation Date
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Description of Marker
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Dimensions of marker base
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Dimensions of marker die
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Marker colour
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Marker design
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Inscription
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Grave Location
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Section # Range # Plot # Grave #
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Placement and other
Instructions
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