Form of Indemnity

ARCHDIOCESE OF LIVERPOOL  -  ST. MARY’S, EUXTON

FORM OF INDEMNITY FOR A BURIAL IN ST. MARY’S CEMETERY

This Form of Indemnity must be completed in all cases of interment in a purchased grave plot if the Grave Deed or Certificate of Right of Burial cannot be produced.  Where the grave number cannot be given, the name and date of the last interment in the grave will be required.  The onus of providing the full and correct particulars of the grave to be opened is an obligation of the grave owner or his/her legal representative.

This Form of Indemnity must be provided to St Mary’s Parish at the address below, or via your Funeral Director prior to the opening of a grave in the event that the Grave Deed or Certificate of Right of Burial cannot be produced. 

 Grave number ………………………………….  Section ………...............................

I (full name) ……………………………………………………………………………….

of (address) ………………………………………………………………………………

…………………………………………………….  Postcode …………………………..        

 q Believe myself to be the owner/assignee of the said Right of Burial

 q Being the personal representative of the late ……………………………..…………….

        whom I believe to have been the owner of the said Right of Burial

HEREBY AUTHORISE the opening of the said grave space for the interment of 

the late …………………………………………………………………………………….

and I undertake to indemnify the Parish of St Mary’s, Euxton

from and against all claims, demands, charges, costs, expenses, actions, liability

or losses which the said Parish or its servants may hereafter suffer as a

result of the interment of the above-named deceased person.

Signed …………………………………………………        Date ……………………………

Send to:

Fr G McCusker

St Mary’s RC Parish

Wigan Road

Euxton

PR7 6JW

 LIVERPOOL ROMAN CATHOLIC ARCHDIOCESAN TRUSTEES INCORPORATED   Registered Charity No. 232709