No Christian and family mumcs cf deccascd

5° Formula of an act of Burial.

The... day of the month of... nineteen hundred and..., We the undersigned parish-priest (or missionary) have given the religious burial, in the cemetery of this parish (or mission) to the body of N... (christian and family name of deceased) (give his or her profession) of this parish ‘(or place, or of such parish or place) or of N... wife of N... (or widow of N... if a woman), or of N... son (or daughter) of N... and N..… (christian and family names of father and mother), deceased on

the... dayrof the month... aged... (give number of years, months or days).

Were present N... and N... who have signed with us (or who- have declared-that-they could not sign). “This act has | been read to them.