Work Order for Foundations and Setting 25 South Main Street Dover, Pa. 17315 Office 717-292-2621 Fax 717-292-7936 E-Mail: info@baughmanmemorials.comCustomer#*Date Submitted* MM slash DD slash YYYY Name* First Last Phone*Preneed or Name?*( Choose "Name" if person is deceased ) Preneed Name Name of Deceased* First Middle Last Date of Death* MM slash DD slash YYYY Name of CemeteryAddress of Cemetary Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Section NumberLot NumberLocation of LotType of Burial* Traditional Burial Cremation Style of Monument Upright Slant & Base Slant Bevel Flush Bronze Not Applicable Base SizeAdd for MarginMarker SizeAdd for MarginDescription of WorkFoundation Location (see below) A B C D This field is hidden when viewing the formFoundation Completed Date MM slash DD slash YYYY This field is hidden when viewing the formDate Set MM slash DD slash YYYY Foundation Completed by First Last SignatureEmailThis field is for validation purposes and should be left unchanged. Δ
