Required fields are marked with asterisks (*)

Monuments and Markers Installation Request Form

FEES

Installation fee for flat marker (less than 173 sq. in)	$0.00
Installation fee for flat marker (at least 173 sq. in)	$100.00
Installation fee for upright monument (4ft or less in height and & length including base)	$200.00
Installation fee for upright monument (more than 4 ft in height or length inclduing base)	$400.00
Fee for inspecting the installation of a marker/marker	$50.00
Fee for marking the location where a marker/monument to be installed	$50.00

Requestor Information

Company

Company Full Address

Contact Name

Phone Number

Email Address

Details of Request

Name of Deceased

Date of Death

Installation Type

New Installation

Remove & Replace

Inscription Only

Plot Location (if known)

Requested Installation Date

Requested Installation Time (approximately)

Would you like a map of the plot location e-mailed to you?

Yes

Additional Information

Please Note: At least three business days notice must be provided for an installation request.

Questions: If you have any questions or require assistance, please contact Municipal Governance Department at 519-733-2305 ext. 247.

Privacy Statement: Personal Information on this form is collected pursuant to the Funeral, Burial and Cremation Services Act and will be used for the purpose of responding to your request. Questions about the collection of this information should be directed to the Clerk for the Town of Kingsville, 2021 Division Road North, Kingsville, ON N9Y 2Y9, Telephone: 519-733-2305.

Monuments and Markers Installation Request Form

Requestor Information

Details of Request

Subscribe to Town News!