Form Of Renunciation - London Borough Of Merton Cemeteries Service
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1London Borough of Merton Cemeteries Service
Form of Renunciation
To be used to surrender any interest in a grave any person may have e.g. when only one child of the deceased is taking
over the Exclusive Right of Burial, this form must be signed by his/her siblings.
This form should be attached to the statutory declaration before the declaration is made and reference to this form should be made
within the
declaration.
I /we*, the undersigned hereby renounce all my / our* interest and title in the Right of Burial described in
the Register as Grave number ___________, Section ___________, Grant number _________________
in London Borough of Merton / Merton & Sutton Joint Cemetery Board, and desire that the said Right of
Burial shall be vested solely / jointly* in my / our* brother / sister*
) _________________________________________________________
(Title, full name of new registered owner
__________________________________________________________________
Of (full address & post code)
_____________________________________________________________________________________
Dated this _______________ day of ______________ 20 _____
__________________________
___________________________
Signature:
Witness signature:
: __________________________
: _______________________________
Title/Full Name
Title/Full Name
______________________________
___________________________________
Address:
Address
:
_____________________________________
__________________________________________
_____________________
_______________________
Post Code:
Post Code:
_________________________
___________________________
Signature:
Witness signature:
: __________________________
: _______________________________
Title/Full Name
Title/Full Name
_______________________________
___________________________________
Address:
Address:
_____________________________________
__________________________________________
:______________________
: _______________________
Post Code
Post Code
__________________________
___________________________
Signature:
Witness signature:
: __________________________
: _______________________________
Title/Full Name
Title/Full Name
: ______________________________
:____________________________________
Address
Address
_____________________________________
__________________________________________
______________________
_______________________
Post Code:
Post Code:
_________________________
___________________________
Signature:
Witness signature:
: __________________________
: _______________________________
Title/Full Name
Title/Full Name
_______________________________
___________________________________
Address:
Address:
_____________________________________
__________________________________________
______________________
_______________________
Post Code:
Post Code:
* Delete as appropriate
th
Cemeteries Office, 13
Floor, Merton Civic Centre, London Road, Morden, Surrey SM4 5DX
Tel: 020 8545 3666, Email:
cemeteries@merton.gov.uk Web:
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