Burial on Private Land Application

Private Burial Application Form

Application for burial on Private Land within the Waratah-Wynyard Municipal Area.

Applicant Details

Applicant details, NOT interment details

First Name (Applicant)(Required)

First Name

Middle Name (Applicant)

Middle Name (If Applicable)

Last Name (Applicant)(Required)

Last Name

Address (Applicant)(Required)

Street Address Address Line 2 City State Post Code Country

Phone (Applicant)(Required)

Mobile (Applicant)(Required)

Email (Applicant)(Required)

FUNERAL DIRECTOR DETAILS

Funeral Director Contact Details

Is funeral director known?

Yes

Not at this time (to be advised later)

Business Name (Optional)

Business Address (Optional)

Street Address Address Line 2 City State Post Code Country

Contact Name (Optional)

First Last

Phone (Optional)

INTERMENT DETAILS

Details of the Intended Interment

First Name (Interment)(Required)

First

Middle Name (Interment)

Middle (If Applicable)

Last Name (Interment)(Required)

Last

Date of Birth (Interment)(Required)

Date of Death (Interment)

Intended Interment Date(Required)

BURIAL LOCATION DETAILS

Location details of Intended Burial

Full Address (Number, Road & Locality)(Required)

Street Address Address Line 2 City State Post Code Country

Location (Coordinates Lat, Lon. Can use LISTmap/Google Maps)(Required)

Location Map (Showing Measurements from Boundaries, Please use LISTmap if possible)(Required)

Upload Now (File upload will appear below)

Email to Council (Please email council@warwyn.tas.gov.au)

Posted to Council

Request Council Callback to Assist

Location Map Upload(Required)

Max. file size: 80 MB.

Written Permission of Landowner(Required)

Upload Now (File upload will appear below)

Email to Council (Please email council@warwyn.tas.gov.au)

Posted to Council

Landowner Permission Letter(Required)

Max. file size: 80 MB.

Private Burial Application Form

Applicant Details

FUNERAL DIRECTOR DETAILS

INTERMENT DETAILS

BURIAL LOCATION DETAILS

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