Plot Purchase Form

This form is to be completed by an individual requesting to purchase a plot or grave at Lewis Cemetery for future needs. All information is used solely for cemetery records and coordination purposes. The completed form will be retained by the Lewis Cemetery Committee as part of its permanent records.

Plot Purchase Form

Section 1 – Purchaser Information

Section 1 – Purchaser Information

First Name of Requestor:

Middle Intial

Last Name of Requestor:

Mailing Address:

Phone Number:

Email Address:

Section 2 – Intended Use (if known)

Section 2 – Intended Use (if known)

Intended Person(s) for Burial (optional):

Relationship to Intended Person(s):

Is this purchase for:

Future need (pre-need)

Immediate need

Undetermined

Section 3 – Burial Plot Information

Section 3 – Burial Plot Information

Number of Burial Plots Requested:

Preferred Plot Location or Area (if available):

Does the purchaser currently own adjacent plots?

Yes

If yes, please describe location (if known):

Section 4 – Payment Information

Section 4 – Payment Information

Has payment been made at the time of this request?

Yes – Paid in full

No – Payment to be processed

Pending / Arranged

Payment Method:

Cash

Check

Online Payment

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I understand that the purchase of burial plots grants the right of burial and does not convey ownership of land. I agree to abide by the rules and policies of the Lewis Cemetery Committee. I understand that this purchase must be recorded and approved by the Committee.

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Useful Links:

About Us
Burials and Plots
Membership Information
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City of Alma Website
Alma City Cemetery

Mailing Address:

Lewis Cemetery Committee

P.O. Box 1962

Alma, AR 72921

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