PROBATE COURT OF HAMILTON COUNTY, OHIO RALPH WINKLER, JUDGE DISINTERMENT OF__________________________________________, DECEASED CASE NO. _______________________ VERIFICATION OF REINTERMENT The undersigned ______________________________________________________________ (Name and Title) of the _______________________________________ cemetery, states that the remains of the above-named Decedent were reinterred on the ________ day of _______________, 20_____, pursuant to the Order of this Court. ________________________________________ Signature ________________________________________ Typed or Printed Name ________________________________________ Cemetery ________________________________________ ________________________________________ Address ________________________________________ Telephone (include area code) FORM 25.4 - VERIFICATION OF REINTERMENT 3/1/2014