LOUISIANA CEMETERY BOARD
3445 N. Causeway Blvd., Suite 509, Metairie, LA 70002
Telephone (504)838-5267 Toll Free 1-866-488-5267 Fax (504)838-5289
Website: www.lcb.state.la.us
ANNUAL REPORT OF STORED MERCHANDISE
INVENTORY LOG (Pursuant to La. R.S. 8:505.1)
For calendar/fiscal year beginning ______________________________________and ending _____________________________________
Name of Cemetery Authority of Other Entity:_________________________________________________________________________________________________________________
Address of Cemetery Authority or Other Entity:_______________________________________________________________________________________________________________
Physical address of stored merchandise:_____________________________________________________________________________________________________________________
(Attach evidence all stored merchandise is insured against casualty and theft.)
Contract
No.
LCB-IL-Report
Rev. 10/12
Date of
Contract
Purchaser
Contract Beneficiary if
different than purchaser
Description of Merchandise
Item
Page_____ of _____
Size
Material
Contract
No.
LCB-IL-Report
Rev. 10/12
Date of
Contract
Purchaser
Contract Beneficiary if
different than purchaser
Description of Merchandise
Item
Page_____ of _____
Size
Material