CEMETERY RECORD

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Surname

___________________________		_____________________________
First and Middle Name		First and Middle Name
___________________________		_____________________________
Birth Date		Birth Date
___________________________		_____________________________
Death Date		Death Date
___________________________		_____________________________
Marriage Date		Military Information
Epitaph:_____________________________________________________
_________________________________________________________
Cemetery Name (also show previous names):________________________________
_________________________________________________________

Highway:______	City:__________________	County: __________	State:______
Lot:__________	Section:________________	Road:____________	Cemetery Book Code:______
Nearest Landmark:________________________________________________
Other Information: ________________________________________________
_________________________________________________________

Created by Linda Kralman-Lambert, ILGenWeb County Coordinator for Effingham County © 1998-2005