E1Form of Assignment of Right of Burial

I, A.B., of , in consideration of the sum of paid to me by C.D., of , do hereby assign unto the said C.D. the exclusive right of burial in [here describe the place], and numbered on the plan of the cemetery made in pursuance of the said Act, which was granted to me [or unto A.B. of ] in perpetuity [or as the case may be] by [here state the name of the company], by a deed of grant bearing date the day of , and all my estate, title, and interest therein, to hold the same unto the said C.D. in perpetuity [or, as the case may be,for the remainder of the period for which the same was granted by the said company] subject to the conditions on which I held the same immediately before the execution hereof. Witness my hand and seal, this day of