Sample provided by the Iowa Insurance Division
[Insert name of cemetery]
[Insert address of cemetery]
DESCRIPTION OF INTERMENT RIGHTS, MERCHANDISE AND SERVICES
[Insert description of interment rights, merchandise and services to be transferred.]
____________________________________________________________
____________________________________________________________
________________________________________________________________________
_____________________________________
____________________________________________________________
________________________________________________________________________
person has any legal or equitable ownership
therein. I/We relinquish all rights, interest and ownership
surrender is irrevocable.
and any attached document(s) (such as
hold (Insert name of cemetery)
ts employees, officers, affiliates and
harmless and indemnify the cemetery against any and all
action, demands, or liability of any kind whatsoever arising
ASSIGNMENT OF RIGHTS AND OWNERSHIP
do hereby irrevocably give,
any and all interest in the above
interment rights, merchandise and services
o the following individual(s):
______________________________________