Application to Transfer Burial Rights Back to Council

Complete this form if you wish to return your interment rights back to Council for a refund.

Application Form

Full Name

Phone

Postal Address

Authority to make this application: I am the person:

In whose name the “Right of Interment” was issued – i.e. the original purchaser of the reserved plot

Approved by the original “Right of Interment” holder to make this application – attach documented proof

As legal representative or Next of Kin of the original purchaser – attach documented proof

Section

Row & Allotment

I declare that I hereby transfer my right, title and interest in the “Right of Interment” to Wollondilly Shire Council

Account Name

BSB

Account Number

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