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OFFICE USE\"Image\"\"Version: 1.0EROB DeedRegister of Burials
Green Form OR Coroner's FormLocation & Grave Space ref
CoffindimensionsKPS booked
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Personal Information of the Deceased
Full name of deceased
Permanent address of deceased at time of death
Was the deceased a parishioner?YESNO(Refer to Parishioner Guidelines at the end of the form)
Age of deceased
Date of Death
Place of Death
Interment Details
Date of Interment
Time of Interment
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Depth of burialSINGLEDOUBLERE-OPEN
Exact Coffin dimensionsLENGTH:WIDTH:HEIGHT:
Officiating Minister – if applicable
Funeral Director Details
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SECTION B continued: Exclusive Right of Burial (EROB) deed holders to complete
As the EROB holder, I consent to this interment. I declare that I have read, understood and agree to comply with the Cemetery Regulations relating to Herne Road Cemetery.
Forenames & Surname
Address (including postcode)
Telephone/mobile number
Email address
Signature of EROB holder:Date:
As the EROB holder, I consent to this interment. I declare that I have read, understood and agree to comply with the Cemetery Regulations relating to Herne Road Cemetery.
Forenames & Surname
Address (including postcode)
Telephone/mobile number
Email address
Signature of EROB holder:Date:
Parishioner Guidelines\nIn order to determine which fees to charge, the Council will use the last permanent address of the deceased.\nIn the case of a former resident who has lived in the parish of Crowborough for at least five years immediately before moving to a residential, care or nursing home outside Crowborough, the parishioner rate will apply for their first five years in the home; after this period the non-parishioner rate will apply.
General Data Protection Regulations\nAll data contained and submitted in this form will be processed in line with our Privacy Notice. You can read our Privacy Notice on our website: https://www.crowboroughtowncouncil.gov.uk/privacy-notice/\nA paper version is available on request from the Cemeteries Officer.
Crowborough Town Council Contact Details
Cemeteries Officers\nCrowborough Town Council\nCouncil Offices, Pine Grove\nCrowborough TN6 1DHTelephone: 01892 652 907\nEmail: cemeteries@crowboroughtowncouncil.gov.uk\nWebsite: www.crowboroughtowncouncil.gov.uk\nOffice hours: Monday to Thursday - 9am to 5pm; Friday - 9am to 4.30pm
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You can read our Privacy Notice on our website: https://www.crowboroughtowncouncil.gov.uk/privacy-notice/\nA paper version is available on request from the Cemeteries Officer.", "html_text": "General Data Protection Regulations\nAll data contained and submitted in this form will be processed in line with our Privacy Notice. You can read our Privacy Notice on our website: https://www.crowboroughtowncouncil.gov.uk/privacy-notice/\nA paper version is available on request from the Cemeteries Officer.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 3, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 15, "location": [ 29.04, 113.9467, 582.72, 154.96 ], "cells": [ { "location": [ 29.04, 113.9467, 582.72, 154.96 ], "text": "Crowborough Town Council Contact Details", "html_text": "Crowborough Town Council Contact Details", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 3, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 16, "location": [ 29.04, 72.9333, 582.72, 113.9467 ], "cells": [ { "location": [ 29.04, 72.9333, 213.6, 113.9467 ], "text": "Cemeteries Officers\nCrowborough Town Council\nCouncil Offices, Pine Grove\nCrowborough TN6 1DH", "html_text": "Cemeteries Officers\nCrowborough Town Council\nCouncil Offices, Pine Grove\nCrowborough TN6 1DH", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 213.6, 72.9333, 582.72, 113.9467 ], "text": "Telephone: 01892 652 907\nEmail: cemeteries@crowboroughtowncouncil.gov.uk\nWebsite: www.crowboroughtowncouncil.gov.uk\nOffice hours: Monday to Thursday - 9am to 5pm; Friday - 9am to 4.30pm", "html_text": "Telephone: 01892 652 907\nEmail: cemeteries@crowboroughtowncouncil.gov.uk\nWebsite: www.crowboroughtowncouncil.gov.uk\nOffice hours: Monday to Thursday - 9am to 5pm; Friday - 9am to 4.30pm", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 2, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 17, "location": [ 29.04, 31.92, 582.72, 72.9333 ], "cells": [ { "location": [ 29.04, 31.92, 582.72, 72.9333 ], "text": "Version: 1.0", "html_text": "Version: 1.0", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 3, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 18, "n_cols": 3, "ref": "#/tables/0", "reading_order": 0 } ] } ]