Richard John CourtrightBLAIR CEMETERY
Blair Nebraska
Permit for Interment
Complete the Following
Relation to Lot Owner
SIGNATURE OF FUNERAL DIRECTOR
I hereby authorize the interment of
Richard John Courtright
in the lot and grave space designated above.
Signature of Relative or
Legal Representative Emily ourtright�
Number
Richard John
Courtri ht
Name of Deceased
75
Date of Birth Januar 11, 1913
St.
Age
Omaha, Nebraska
Home Address 4820 Magnolia
Omaha
Nebraska
Place of Death
Single, Married or Widowed
Married
White
Race
Pendin cr
Cause of Death
November
11, 1988
Date of Death
14, 1988
ate of Interment
Date
Wife: EmilXT Courtri ht
Nearest Relative
In Whose Lot Interred
Own
3
Lot q Section
>_� _ � �----
Block
—Grave
Yes Vault Co.
—
Vault Wilbert Continental Box
Tent �;
Relation to Lot Owner
SIGNATURE OF FUNERAL DIRECTOR
I hereby authorize the interment of
Richard John Courtright
in the lot and grave space designated above.
Signature of Relative or
Legal Representative Emily ourtright�