Official Nebraska State Website
Nebraska Historical Society

Nebraska Statewide Cemetery Registry (NSCR)
Registration Form

Printable Form (PDF 193k) (Please use this option to print a blank form if you are unable to complete the required fields in the online form.)

(Note: Fields marked with * are required)
* 1. Name Of Cemetery Entity:
   Definition (opens in new window)
Alternate Names
2. Physical Address:
Street/Road/Etc.
City/Town/Village
State
Zip Code
3. Location Name:  
  Cemetery/entity is inside corporate limits of the city/town/village listed above
  Cemetery/entity is outside corporate limits of the city/town/village listed above
4. Legal Description: (Not required if located within city/town/village limits):
  Precinct
  Quarter
  Section
  Township
  Range
  Longitude/Latitude
(if known)
5. County:  
  * County Name
6.  Type (Check ALL that apply, for example, a cemetery (marked tombstones, etc.) with mausoleums (building with burial vaults) and columbaria (vaults for cremated remains in urns) should check all three):
  Cemetery
  Mausoleum
  Columbarium
  Unmarked Graves/Burial Grounds Native American Unknown
Archeological Site
  Other (Specify)
7. Is Cemetery Entity Located On Public Or Private Land? Definition (opens in new window)
 
  Public Private Unknown
8. Establishment Date(s)
  Unknown
9. Abandonment Date(s)
  Unknown
  Not Abandoned
10. Does a plat map exist? Definition (opens in new window)
    Yes No
  Unknown
  Not applicable
  If yes, please provide a copy to the NSHS (this is desirable, but funding is not available to reimburse for reproduction expenses).
  Comments
11. Do burial/lot records exist? Definition (opens in new window)
    Yes No
  Unknown
  Not Applicable
  If they exist, are they available for public inspection?
    Yes No
Comments
12. Have tombstone transcriptions been compiled? Definition (opens in new window)
    Yes No
  Unknown
  Not Applicable
  If yes, please provide access information: Definition (opens in new window)
  Source title (if available in a published text provide title, author, date of publication, etc.)
 
  Web address (if transcriptions have been placed on the World Wide Web)
 
  Other (provide name of individual, institution, etc. where the copy or copies of listings are available for public use)
 
   
13. Submitter's Name (name of individual who is providing information on this questionnaire):
  * Name
  Representing
  * Address
  City
  State
  Zip
  Phone
  Fax
  * E-mail
  * Should this name and address be the initial contact for this cemetery entity?
  Yes No
  If no, which contact (Owner, Operator, Custodian) should be listed?
 
PLEASE RECORD AS APPLICABLE:
14. Owner:  
  Same as Submitter
  If not please provide:  
  Name
  Representing
  Address
  City
  State
  Zip
  Phone
  Fax
  E-mail
15. Operator:  
  Same as Submitter
  If not please provide:  
  Name
  Representing
  Address
  City
  State
  Zip
  Phone
  Fax
  E-mail
16. Custodian:  
  Same as Submitter
  Same As Owner
  Same As Operator
  If not please provide:  
  Name
  Representing
  Address
  City
  State
  Zip
  Phone
  Fax
  E-mail
17. Additional Comments, Notes, Etc.
   
 

 

Thank you for completing this questionnaire. Please print a copy of the completed registration form for your files. INITIAL DEADLINE WAS OCTOBER 1, 2006. Registrations will continue to be accepted. You may be contacted in the future for further verification. A copy of your registration form should be maintained with the records of the cemetery entity and reviewed on a regular basis. Updates should be sent promptly to the Registry. Registrants on file will be contacted every ten years for verification.

Questions may be e-mailed to cemetery@nebraskahistory.org. Registration information will be available to the public by July 1, 2007. If not posted at this site (www.nebraskahistory.org), contact the address listed below. REMINDER: Any changes of addresses, etc. in the future for a cemetery entity contact should be submitted to the Registry.

Nebraska State Historical Society
Statewide Cemetery Registry
P.O. Box 82554
Lincoln, NE 68501-2554
Phone: 402-471-4784
Fax: 402-471-8922