Form of Grant of Right of Burial

By virtue of [here name the special Act], we [here state the name or description of the company], in consideration of the sum of to us paid by , of , do hereby grant unto the said the exclusive right of burial [ or the right of burying bodies, as the case may be,] [or the right of placing a monument, tablet, or gravestone,] in [here describe the ground intended for the exclusive burial, or for placing a monument, tablet, or gravestone, as the case may be, so as to identify the same, and if a place of exclusive burial, add “numbered on the plan of the cemetery, made in pursuance “of the said Act,”] to hold the same to the said in perpetuity [or the period agreed upon] for the purpose of burial [or as the case may be]. Given under our common seal, [or under our hands and seals, as the case may be,] this day of in the year of our Lord