Sales Card
No.
APPLICATION   AND   AGI
(Purchase of Debentures)
Date
0§_,
FOREST  LAWN  MEMORIAL-PARK  ASSOCIATION
1712 South Glendale Avenue
Glendale, California 91209
□ GLENDALE
m HOLLYWOOD HILLS
□ CYPRESS
□ COVINA HILLS
I hereby make application, subject to your acceptance, for the purchase from you of three per cent convertible
debentures issued by Forest Lawn Company of the aggregate par value as shown below, the particular debentures
to be of such series, denominations, and due date as you may select and specify below.
Forest Lawn Company 3% Debentures, Series
Smrittl Mm* SB«*473« SB*2?0	
S,  dtttt Jang 1,   19BQ
I agree to pay the Balance shown below as follows:
Par value $.
Paid
Herewith 	
Jalance
A AJ
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or more, heir inning on the
dav of
in    r*>£■     monthly installments of S   -■'•■,/■'
19 -a /, and each succeeding month thereafter.
In consideration of there being no interest charged on my obligation, you shall collect and retain interest paid
on the debentures until they are paid for in full.
IT IS MY UNDERSTANDING THAT I WILL BE ENTITLED TO AN "EARNED INTEREST CREDIT"
OF THREE PER CENT PER ANNUM ON ALL AMOUNTS PAID BY ME ON THE PURCHASE OF THE
DEBENTURES payable after payment of the last installment.
Effective immediately upon your acceptance of this application and agreement, title to The debenture selected
and specified above shall pass to me, but registration shall remain in your name, and I hereby PoW -Hid deposit
with you said debentures as collateral security for The payment of my obligation. Thi* aj.m-me.il and ihe pledge
of said debentures are subject to and enforceable upon the terms and conditions on the reverse hereof.
I understand that said debentures, when paid for in full, are acceptable at their full par value in exchange
for services, property or commodities rendered by a Forest Lawn Mortuary operated by you, and I am purchasing
said debentures to be applied on the cost of funeral services to be furnished by said mortuary.
I understand that said debentures are not offered or sold except to residents of the State of California. I
therefore certify that my legal domicile is the State of California and that I have been a resident of California
for jPP   years continuously last past, and that it is my intention to remain a resident of such State.
Purchaser's
Signature " _	
Witness      ._;..-_...._._...
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Print Signature
Vprifirntirm
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Purchaser's
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Street and Number
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City
State
Zip Code
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Purchaser's Social Security Number
FOR OFFICE USE ONLY
Pg-22529-CP
Purchaser's Telephone
Representative      ■■....P-
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Aceepted:   FOREST LAWN MMORIAL-PARK ASSOCIATION
77
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Seller
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413     1/65