Purpose of the Records of Interments of Confederate Veterans Committee, UDC

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Records of Interments of Confederate Veterans Committee

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NAME AS IT APPEARS ON GRAVE MARKER
Last name:
First and Middle name:
ALTERNATE NAME
Last name:
First and Middle name:

MILITARY SERVICE
Rank: Company: Regiment: ServiceState:

Type:

Infantry:
Cavalry:
Artillery:
Engineers:
Generals & Staff:
CSN:
CSMC:
Other:
If Other, explain:
Civilian:
If Civilian, explain:

Reference Source:
Date of Birth:
Place of Birth:
Date of Death:

Additional information

CEMETERY INFORMATION
Cemetery Name:
Cemetery Manager:
Cemetery Address:
Cemetery Location (if address unknown):
Cemetery Telephone (use (XXX)XXX-XXXX format):
Is there a gravestone?: Yes
Is Confederate service listed?: Yes
Is it a memorial marker (no remains)?: Yes
Is there an Iron or Brass Cross?: Yes
If Iron or Brass Cross, who placed it?:
If no gravestone, describe location of grave:
SUBMITTER (Optional Section)
Name of submitter:
Submitter Telephone (use (XXX)XXX-XXXX format):
Submitter e-mail:
Submitter Chapter Name:
Submitter Chapter Number:
Submitter Chapter City:
Submitter Chapter Divison/State:

Date Form Submitted: