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White Jr, Frank AINST # 9b-U19y--)4 JAN 24, 1996 3:25PM CEMETERY DEED THIS INDENTURE made this W day of 1996, between the City of Clearwater, Florida, a mun' pal corporati as Grantor and Mr. FRANK A. WHITE, JR. whose mailing ad ss is 1203 Pennsylvania Avenue, Clearwater, FL 34615, of the County of Pinellas, State of Florida, as Grantee: FOR INTERMENT OF: FRANK A. WHITE, SR. WITNESSETH: That the said Grantor, for and in consideration of the sum of $500.00, to it in hand paid by the said Grantee, the receipt whereof is hereby acknowledged, has remised released and quit-claimed unto the said Grantee, and his heirs forever, all the right, title and interest, which the said Grantor has in and to the following described parcel of land, lying and being in Pinellas County, State of Florida, to wit: Space One 11) Lot One Hundred Nine (109), Block Fifteen (15), Clearwater Cemetery, as recorded in Plat Book 60, Page 30, Public Records of Pinellas County, Florida. RETURN TO: CITY CLERIC POST OFFICE BOX 4748 CLEAR"LATER, FL 34618-4748 PINELLAS COUNTY FLA. OFF.REC.BK 9227 PG 1965 This conveyance is subject to the condition that Grantee herein shall not assign or convey said property without the written consent of the Grantor, and to the further condition that said property shall be used only for cemetery purposes as human burial sites and is subject to such other rules and regulations the City of Clearwater may adopt pertaining to use of said property. TO HAVE AND TO HOLD the same to the only proper use, benefit, and behoof of the said Grantee and his heirs and assigns forever. IN WITNESS WHEREOF, said Grantor has caused these presents to be executed in its name by its Mayor Commissioner, by its City Manager, and to be attested and its corporate seal affixed by the City Clerk on the dayand,year, tirsitabove written. Cou r 'fined: CITY OF CLEARWATER, FLORIDA 'Z 5" Rita Garvey, Mayor-Com loner STATE OF FLORIDA ) COUNTY OF PINELLAS) By: Elizabe D ule, ity M a er = Attest: ?7i _ Susan Stephenson;,Depilty Ci Clerk, Before me, the undersigned, personally appeared Rita Garvey, the Mayor-Commissioner of the City of Clearwater, Florida, to me well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act and deed for the use and purposes herein set forth. rt-_ WITNESS my hand and official seal this Elio day of 194 (SEAL) P J'?± t;fj??tl) I„ P4. 'N otary Public L- Ti, # UC dE20I0 Print/type name: 12,1409 ROND?^ THRU STATE OF FLORIDA )oF F??? ATLANTIC BONDING CO., INC. COUNTY OF PINELLAS) Before me, the undersigned, personally appeared Elizabeth M. Deptula, the City Manager of the City of Clearwater, Florida, to me well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act and deed for the use and purposes herein set fo 14 WITNESS my hand and official seal this day of , 1996a (SEAL) hp1,,INk4otary Public Approved as to formal sufficiency: Print/type na e: 46 , Ct" t ?0 463040 `? GJ?: E 7 iRU ?Z P, n Carassas, Assistant City Attorney '•pF F?°Q LAt? IC e? • ??o ca INr3? ?- J Y Y ?? ?• M C.) Documents Tex Pd. S OU ?? f Intangible Tax Pd. W F- W rn U U CV U) Karleen F. a Is Clerk, Pinellas County W LL U O Lu CL (1) F- U W W O Deputy. Clerk ?QUCE0O-(I u_? F- By PURCHASE OF CEMETERY SPACE CHECK LIST ?j •. DATE: OWNER'S NAME /21qAM(-" PHONE NUMBER ADDRESS Z2 3 /&f'1 1.???/Gcf?-t cam. A4-Ve . " eL?/ 31??` S BLOCK ? LOT A0 ? SPACE ? / '' II// ?11 r INTERRED: COST OF SPACE RECORDING FEE RECEIPT NO. R STAKING FEE TOTAL (trtctude County, ij other than Pinetfnc) $ 500 0 0 Z?Z, 0 $ 30, 0 o $ 00- The Purchaser will first visit the cemetery and obtain the legal description of the space selected fi•onr the caretaker at the cemeter The following steps shall then be followed in their listed order. ? heck Availability of space repare receipt for purchaser 4-- c1c) Color in green plat (located in binder in overhead cabinet at receptionist's station NOTE. F LOTWNG 1 PS WILL; BE HANDLED `B.I'`EMPLOI?ES WHO ARE ROU77NE'LY': PONSIRL FOR CEU=, RECORD KEEPING. IF THIS IS ANA T-NEED PURCHASE PLEASE SEE ADDITIONAL STEPS FOR AT NEED USE OF SPAC ........ PTERtYIEN " AT'BOTTOM OF'PAGE,' Fill'in ownership it formation in 4YOwrrership Book / Prepare decd for each space purchased Fill in Florida Dept. of Revenue form Prepare routing memo to route decd and revenue form for signatures and route _.?_LEnter document information re deed in Document Tracking System After deed is returned to Clerk Dept. fully executed, send for recording and enter necessary it formation ill Document Tracking System When deed comes back from recording, mark colnpleted in ocument Tracking System Prepare transmittal letter sending deed to owner,, enter in Document Tracking S •tcr r File copy of deed in cemeteryf les in vault ADDITIONAL STEPS FOR AT-NEED USE OF SPACE (INTERMEN7) V Fill out burial permit (located in overhead cabinet at Receptionist's station) Fax permit to cemetery and parks -Prepare receipt when staking fee ($30.00) is received front Funeral Home WSAAn CEMCV=..FRM June 2T, 1994 C I T Y OF C L E A R W A T E R POST OFFICE BOX 4748 CLEARWATER, FLORIDA 34618-4748 Department of the Clty Clerk (813) 462-6684 January 29, 1996 Mr. Frank A. White, Jr. 1203 Pennsylvania Avenue Clearwater, FL 34615 Dear Mr. White, Enclosed is the Cemetery Deed, which indicates that you own Space One (1), Lot One Hundred Nine (109), Block Fifteen (15), in the Clearwater Cemetery which has been used for the interment of FRANK A. WHITE, SR.. This deed has been recorded in Official Records Book 9227, Page 1965. It is important to keep this deed in a safe place and to make a separate note of the official record book and page numbers. In the event the original deed is lost or destroyed, this information will be needed to obtain a copy from the Pinellas County Clerk of the Circuit Court. call. If we may be of service in the future, please Yours very truly, Susan Stephenson, Documents & Records Supervisor SS: cm Enc. -Equal Employment and Affirmative Action Employer"