Tabor, Kim Marie Mortlake Crematorium (1 .
Kew Meadow Path, Richmond, Surrey, TW9 4EN
Telephone: 020 8876 8056
Cremation No: 198503
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THIS IS TO CERTIFY
that the late Kim Marie Tabor of 80 Lawrence Road Ealing London who died on the
25th June 2022 at 80 Lawrence Road, Ealing, London, W5 4XH and whose death
was registered at the district of Ealing was cremated at Mortlake Crematorium on the
5th July 2022 and that the Registrar's Certificate for Cremation, dated 29/06/2022,
reference DIS38 897415, has been produced to the Medical Referee and filed by me in
accordance with the Regulations made under Section 7 of the Cremation Act 1902 and
Section 2 of the Cremation Act 1952.
The Notification Certificate of Disposal (Part C) has been returned to the Registrar for
the District where the death was registered.
DATED 06/07/2022
Signed C �. _x . .
on behalf of Mortlake Crematorium Board
CollectCertificate-M ortlake
BCL 569306
CERTIFIED COPY G . OF AN ENTRY
QF; \OF
Pursuant to the Births and -? = Deaths Registration Act 1953
DEATH Entry No. 14
Registration district Ealing Administrative area
Sub-district Ealing London Borough of Ealing
1. Date and place of death
Twenty-fifth June 2022
80 Lawrence Road Ealing
2. Name and surname 3. Sex
Kim Marie TABOR Female
4. Maiden surname
of woman who
has married
5. Date and place of birth
Twenty-fourth September 1957
United States Of America
6. Occupation and usual address
Carer
80 Lawrence Road Ealing
7.(a)Name and surname of informant (b) Qualification
Philip David MANNEY Son
Present at the death
(c)Usual address
80 Lawrence Road Ealing
S. I certify that the particulars given by me above are true t+,the best of my knowledge and belief
Signature
P Manney of informant
9. Cause of death
I(a)Metastatic Oesophageal Cancer
Certified by Andrew Theivendra Dharman 1Vr '
10. Date of registration 11. Signature of registrar
Twenty-ninth June 2022 R Nunoo
Deputy Registrar
Certified to.. e a true c y of an entry in a register in my custody. [
* ei ttende1* 2 gistrar Date `-V •
*Registrar
*Strike out whichever does not apply
O'Dwyer
Independent Funeral Directors
137 Little Ealing Lane
f i Ealing
London
W5 4E]
020 3067 0068 (24 hours)
�.-.- www.odwyerfunerals.co.uk
don@odwyerfunerals.co.uk
Our Reference:Tabor
Tuesday,27 September 22
TO WHOM IT MAY CONCERN;
I, Anthea Barrett, Funeral Director of
O'Dwyer Funeral Directors Ltd.
137 Little Ealing Lane, London W5 4EJ,
solemnly and sincerely declare as follows: -
that the ashes and only the ashes of the late Kim Marie Tabor
who died at home 80 Lawrence Road, London W5 4XH on 25th
June 2022 and was cremated at Mortlake Crematorium (Ref:
198503) on 5th July 2022 are contained in this cremation
container.
The deceased was free from infection at the time of death.
Signed 711-va .
(signature of Funeral Director)
Date°P79?/?--
O'Dwyer Funeral Directors limited is a registered company no.10294603.
TABOR
NAME Kim Marie Tabor Age: 64
Lot Owner: Tabor Family Plot
Lot# Grave# On Top
Family Plot Mom(Margret)
Case: Urn
Died: 6.2 5.2 2 Interred: 1 0. 1 7.2 2
Funeral Home:Fami ly Toby Tabor
Cemetery: Mt Hermon