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Battle, Jannie• Date: Cemetery Call Work Sheet Funeral Home/ Monument Company: Contact Name: J4.h'.0's 13Z?? Sr . p le ) 'f?a-65`3 X123- Tel. #: Fax #: Reason for call: L-'Y c ?c Na. 36a5d a0oo i.J4.'? l per, e o? Jr bO ?. 13 0?o c? ?, ,wc...4,() e-w. a Lv i ?-Q Gc•-QX ?.-? Y, oo Deceased Name: Date of Birth: off' l °S l ?9?? Date of Death ° 7 • Block (G Lot 3 1 Space -?-- Owner of Plot: Interment: (One full burial and one urn, or two urns per space) Full Burial Urn Space $30.00 Staking Fee - received on: 13 / °/ / ° 7 Date of Burial: 3 / 3 7 Time: -? ° a rn?prn Disinterment: The following authorization should be obtained prior to disinterment: 1.) A disinterment permit and burial/cremation transit permit 2.) Written authorization from the individual(s) who currently own the burial rights for the plot; and 3.) Written authorization from the individual(s) who would be permitted to authorize burial Monument Being Placed: (No Fee for Staking of Monument) • N 0- t : N a-Z A -{ o AZr Act j f---t, 1A r, ? <7 ffte +/'3 ??a?rn &,V- IIIlI1Ii ii CITY OF CLEARWATERf FLORIDA -Q? MISCELLANEOUS RECEIPT '??'ATER,FII' 11 Received from J?)ez In payment of '-e -J S p-L c e- Amount received 711 % °^ 1 It P. a6.1 ollars Fund Code y ( r)Cs,-vats bi=.J A Lt `J. 011) CITY OF CLEARWATER $ ?s' v `' ((;?k ) Q P- L-S Department • N® 433375 Date Y"? 0 20 5252 021907 25800234747 Bertha L Young 1531 S ter, FL ?,rAve a'7 Clearwater, FL 33756-2145 Date v/ 70-7001/2719 ? offer valid until May 18, 2007 Pay to the $?q order of Q? Y a k USA NA_ 1301 East To- Mad, Schaumb>601 73 Check cashing not a a table at HSBC branch s p s ? i.? HSBC Bank Nevada, N.A., Las Vegas, NV Payable t u h HSBC B ORCHARD BaNIC - Meng: 6.9% APR fixed until Paydo n* 1:27L970010: 2S80 02 34 74Iii' 36250 ? s 3 l S. ? ?,n.. sue - C'u No. `t a- I - 2-1( 4--, Received' • Vaughan. Karen rom: Vaughan, Karen nt: Thursday, March 01, 2007 11:11 AM o: King, JoEllyn; Taylor, Joe; Lewis, Eric Cc: Frith, Renee; LaCosse, Judith Subject: Staking Request / Jannie Battle / RUSH!I Importance: High Hello! We've got a RUSH staking request for you. The funeral for Jannie Battle (mother of James Battle, Parks & Rec employee) is being held this Saturday, March 3rd at 1:00. Please flag Block 16, Lot 31, Space 2 for Woody's Funeral Home. They would like to be notified when it's flagged so they can prepare the gravesite as soon as possible. Please email me as soon as the flags are up. I'm faxing you a map also. Other burials in Block 16, Lot 31: Space 1 -Will Sullivan Space 3 - David Tillman Space 4 - Clara Benjamin Thanks! Karen Vaughan 0r. Staff Assistant fficial Records and Legislative Services Phone: 727-562-4091 Fax: 727-562-4086 karen.vaughan@myclearwater.com C] 1 • F- -I • J 5 ? 8 Y SI 32 !S S4 - 37 36 S9 40 30 29 26 27 ? 21 23 22 21 It 112 IS 14 IS 18 li I• 19 20 10 a a 7_1 B I s 14 1.3 1 2 1 1 1 111 112 113 I1/ IIS 118 117 IIB 119 120 110 109 108 107 106 IOS 104 103 102 101 91 92 93 94 95 96 97 96 99 100 90 89 88 87 86 85 81 83 82 61 71 72 73 74 77 79 79 BO 10, 69 60 67 64 63 62 61 yl 52 53 34 SS S6 57 "59 60 50 49 46 47 46 4S 44 43 42 41 31 S2 33 34 SS 36 37 38 39 40 30 29 26 27 26 23 24 R23 22 21 10II 12 13 14 IS I6 17 ISl 20 9 B 7 6 S 4 _I_ 11567 1568 569 370 571 572 373 574 S7y 576 568 365 364 563 562 561 156015591558[55j? 547 548 549 SSO - 553 554 555 536 54 54 3 543 540 539 338 537 1Q 1141 1 527 528 529 530 531 532 533 534 535 536 526 525 524 523 522 521 520 519 518 517 SO7 SOB 509 SIO 311 512 513 r- m 506 SOS 504 503 502 501 500 i o 3 SE E SWEET 3 RT'L_F U M * Z n ? 2a 29 3o 31 32 33 34 35 36 27 26 25 24 - 21 20 19 10 11 12 13 IB 17 IS 9 • 7 6 5 4 3 2 1 96 T3 T2 19 48 25 24 98 9S 74 71 SO 47 28 23 2 I 7 46 27 22 S M J, S 4S 2B 21 4 101 92 77 68 (D 29 20 5 102 91 76 87 30 19 6 103 90 79 66 5S 42 31 IB 7 104 89 BO 65 36 41 2 17 6 105 68 el 64 S7 40 SS 16 9 106 8T 82 63 Se 39 34 IS 10 107 88 63 62 S9 38 3S 14 11 85 84 61 60 37 38 li 3s se 37 3B O - 12 Il 10 9 le IS 14 13 • 7 6 5 4 3 2 1 24 23 22 19 is 17 14 15 16 9 10 11 8 7 6 S 4 3 2 1 73 7 9S 74 1941 75 70 SI_. 16 27 22 3 93 76 69 62. 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II B 3 IB IS El 3 C )0 ??` 19 12 9 2 6 )I 4 10 1 20 II IO 1 4 32 12 19 21 24 2S i6 29 33 2 13 IB 22 2! 26 27 30 34 I TC r r D VJ X?} 1 r. m /C cn n r r n V ! m m KEN BURKE, CLERK OF COURT PINELLAS COUNTY FLORIDA INST# 2007082450 03/09/2007 at 02:10 PM OFF REC BK: 15677 PG: 1519-1519 RECO CEMETERY DEED DocT OOCSTAMP $350RDING: $10.00 THIS INDENTURE made this 2nd day of March , 2007, between the City of Clearwater, Florida, a municipal corporation as Grantor and JAMES BATTLE, SR, whose mailing address is 1531 S. Washington Ave., Clearwater, FL 33756 County of Pinellas, State of Florida, as Grantee: WITNESSETH: That the said Grantor, for and in consideration of the sum of $500.00 'rn hand paid by the said Grantee, the receipt whereof is hereby acknowledged, has remised, released and quit-claimed unto the said Grantee, and their 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 Two (2), LOT Thirty-One (31), BLOCK Sixteen (16), Clearwater Cemetery, as recorded in Plat Book 60, Page 30, Public Records of Pinellas County, Florida. 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 cernetery 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 their heirs and assigns forever. IN WITNESS WHEREOF, said Grantor has caused these presents to be executed in its name=by,_ its Mayor, by its City Manager, and to be attested and its corporate seal affixed by the City Clerk on the day and year first above,written,' Count igned: CITY OF CL A ER,_ j=RIDA fry% By raKk V. Hibbard, Mayor Willi B. or e, II_ Pity; Manager nt+p?t .? , 2 s? e Mary K. Difya,j Assista nt City Clerk STATE OF FLORIDA v COUNTY OF PINELLAS) Before me, the undersigned, personally appeared Frank V. Hibbard, the Mayor 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. WITNESS my hand and official seal this day of 2007. . Notary Public Print/type naa..,144e- DIANE E MANNI STATE OF FLORIDA ) MY COMMISSION # DD526033 COUNTY OF PINELLAS) EXPIRES: Mar. 6,2010 Before me, the undersigned, personally appeared William B. Horne, II, the Cit M;?ma of therG+llyr, apelater, lorida, to me well known to be the person who executed the foregoing instrument and acknowl ge e c o free act and deed for the use and purposes herein set forth. WITNESS my hand and official seal this q?^ day of fy?f ? 2007. ` Notary Public • t '; ''? fL'' Print/type name:-<: Approved as to form: T_• f Leslie K. Dougall-Sides, s 'stant City Attorney SAN M HARRIGER MY COM MISS10N # DD 278716 . I EXPIRES: January 4, 2008 Banded Them Notary Public Urderw hers CEMETERY DEED.DOC RETURN TO: Official Records & Legislative Services P. O. Box 4748, Clearwater, FL 33758 9700-0026 Rev. 3/07 CEMETERY DEED THIS INDENTURE made this 2nd day of March , 2007, between the City of Clearwater, Florida, a municipal corporation as Grantor and JAMES BATTLE, SR, whose mailing address is 1531 S. Washington Ave.. Clearwater, FL 33756 County of Pinellas, State of Florida, as Grantee: WITNESSETH: That the said Grantor, for and in consideration of the sum of $500.00 in hand paid by the said Grantee, the receipt whereof is hereby acknowledged, has remised, released and quit-claimed unto the said Grantee, and their 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 Two (2), LOT Thirty-One (31), BLOCK Sixteen (16), Clearwater Cemetery, as recorded in Plat Book 60, Page 30, Public Records of Pinellas County, Florida. 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 their heirs and assigns forever. IN WITNESS WHEREOF, said Grantor has caused these presents to be executed in its name by its Mayor, by its City Manager, and to be attested and its corporate seal affixed by the City Clerk on the day and year first above written. Countersigned: CITY OF CLEARWATER, FLORIDA Frank V. Hibbard, Mayor By: William B. Horne, II, City Manager Attest: Mary K. Diana, Assistant City Clerk STATE OF FLORIDA ) COUNTY OF PINELLAS) Before me, the undersigned, personally appeared Frank V. Hibbard, the Mayor 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. WITNESS my hand and official seal this day of 2007. Notary Public Print/type nam STATE OF FLORIDA ) COUNTY OF PINELLAS) Before me, the undersigned, personally appeared William B. Horne, II, 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 his free act and deed for the use and purposes herein set forth. WITNESS my hand and official seal this day of 2007. Notary Public Print/type name: Approved as to form: Leslie K. Dougall-Sides, Assistant City Attorney CEMETERY DEED.DOC RETURN TO: Official Records & Legislative Servi P. O. Box 4748, Clearwater, FL 3 +b Copy Serf ? 0 e %,,/Le644? 9700-0026 Rev. 3/07 I FLORIDA DEPARTMENT OF REVENUE FDOR10240300 I RETURN FOR TRANSFERS OF INTEREST IN REAL PROPERTY pilliopERTtr iSER R. o-219 (PLEASE READ INSTRUCTIONS BEFORE COMPLETING) Use black ink. Enter numbers as shown below. If typing, enter numbers as shown below. 1. Parcel Identification Number o 0 o o a© o a o? 11 0 J?6o ?? (If Parcel ID not available ?g5 q pAlpPaeecall County r'sOffice)P-1111,????l-II??t?Jl_ll-J 00 00 22I?JL?J????????? Transaction is a split Property was improved 2. Mark (x) all Multi-parcel or cutout from with building(s) at time that apply transaction? -? 1111 another parcel? D of sale/transfer? _+ ? 3. Grantor (Seller): CITY OF CLEARWATER Last First 112 S. OSCEOLA AVE. Mailing Address 4. Grantee (Buyer): BATTLE, SR. JAMES MI Corporate Name (if applicable) CLEARWATER FL 33756 (7275)624090 City State Zip Code Phone No. Last First MI Corporate Name (if applicable) 1531 S. WASHINGTON AVE. CLEARWATER FL 33756 ( 7274212162 Mailing Address City State Zip Code Phone No. 5. Date of Sale/Transfer Sale/Transfer Price ?l ? o'?l ? $? ? ?,D04_ ,? ,? ? ? . (? 01 Located In 62 - Pinellas Month Day Year (Round to the nearest dollar.) 6. Type of Document ? Contract/Agreement Other 7. Are any mortgages on the property? If "Yes", YES ? ! ? NO for Deed outstanding mortgage balance: Warranty Quit Claim n Deed (Round to the nearest dollar.) $ ? ? 11'11? ? I I ? ? o1 Deed F1 8. To the best of your knowledge, were there unusual circumstances or conditions to the sale/transfer such as: Forced sale by court order? Foreclosure pending? Distress Sale? Title defects? Corrective Deed? Mineral rights? YES ? NO Sale of a partial or undivided interest? Related to seller by blood or marriage. 9. Was the sale/transfer financed? YES D / U NO If "Yes", please indicate type or types of financing: Agreement or Conventional Seller Provided [] Contract for Deed ? Other ? Institutional/ 10. Property Type: Residential Com strial Agricultural Miscellaneous ercial Ind Government Vacant Acreage Timeshare m u Mark (x) a h 11 ? [I l ? ? 1 *C] ? ? t at apply i l-I 1 71. the best of your knowledge, was personal property YES E] o NO Cents $ ? ? ? ? r ?? ? j ? o n in included in the safe/transfer? If "Yes", please state the I_ I II I ?J (v? amount attributable to the personal property. (Round to the nearest dollar.) 12. Amount of Documentary Stamp Tax 10. $ ? 11 1 Z ? 4 1 I 11 ?? / 13. If no tax is due in number 12, is deed exempt from Documentary Stamp Tax under s. 201.02(6), Florida Statutes? YES D I ENO Under penalties of perjury, I declare that I have read the foregoing return and that the facts stated in it are true. If prepared by someone other than the taxpayer, his/her declaration is based on all information of which he/her has any knowledge. L Signature of Grantor or Grantee or Agent Date WARNING: FAILURE TO FILE THIS RETURN ORALTERNATIVE FORM APPROVED BY THE DEPARTMENT OF REVENUE SHALL RESULT IN A PENALTY OF $25.00 IN ADDITION TO ANY OTHER PENALTY IMPOSED BY THE REVENUE LAW OF FLORIDA. To be completed by the Clerk of the Circuit Court's Office Clerks Date Stamp This copy to Property Appraiser O. R. Book ? ? 1111 and Page Number 11]1111 File Number ' and ?????[1111 1111 j? _ Date Recorded ? 11 / ? ? / ? ? ? I Month Da Year This copy to Property Appraiser DO FDOR1 24 300 FLORIDA DEPARTMENT OF REVENUE RETURN FOR TRANSFERS OF INTEREST IN REAL PROPERTY tffT R. 07/98 (PLEASE READ INSTRUCTIONS BEFORE COMPLETING) Enter numbers as shown below. If typing, enter numbers as shown below. 1. Parcel Identification Number 0 1 2 3 4 5 6 7 8 9 0123456789 (If Parcel ID not available please call County Property 22-29-15-00000-220-0400 Appraiser's Office) -+ Transaction is a split Property was improved 2. Mark (x) all Multi-parcel or cutout from with building(s) at time X that apply transaction? of sale/transfer? another parcel? _+ CITY OF CLEARWATER 3. Grantor (Seller): Last First MI Corporate Name (if applicable) 112 S. OSCEOLA AVE. CLEARWATER FL 33756 ( 7275624090 Mailing Address City State Zip Code Phone No. BATTLE, SR. JAMES 4. Grantee (Buyer): Last First MI Corporate Name (if applicable) 1531 S. WASHINGTON AVE. CLEARWATER FL 33756 ( 7271212162 Mailing Address City State Zip Code Phone No. 5. Date of Sale/Transfer Sale/Transfer Price 2 27 2007 $ $500 Property -62 County Code O O Located In Month Day Year (Round to the nearest dollar.) 6. Type of Document Contract/Agreement Other 7. Are any mortgages on the property? If "Yes", YES NO for Deed outstanding mortgage balance: Warranty Quit Claim Deed (Round to the nearest dollar.) Q Q Deed 8. To the best of your knowledge, were there un usual circumstances or conditions to the sale/transfer such as: Forced sale by court order? Foreclosure pending? Distress Sale? Title defects? Corrective Deed? Mineral rights? ES X NO Y Sale of a partial or undivided interest? Related to seller by blood or marriage. 9. Was the sale/transfer financed? YES X NO If "Yes", please indicate type or types of financing: Agreement or Conventional Seller Provided Contract for Deed Other Institutional/ 10. Property Type: Residential Commercial Industrial Agricultural Miscellaneous Government Vacant Acreage Timeshare Mark (x) all x that apply Cents 11. To the best of your knowledge, was personal property YES X NO $ O 0 included in the sale/transfer? If "Yes", please state the • amount attributable to the personal property. (Round to the nearest dollar.) $ 3.50 12. Amount of Documentary Stamp Tax 10 13. If no tax is due in number 12, is deed exempt from Documentary Stamp Tax under s. 201.02(6), Florida Statutes? YES NO Under penalties of perjury, I declare that I have read the foregoing return and that the facts stated in it are true. If prepared by someone other L than the taxpayer, his/her declaration is based on all information of which he/her has any knowledge. Signature of Grantor or Grantee or Agent Date WARNING: FAILURE TO FILE THIS RETURN OR ALTERNATIVE FORM APPROVED BY THE DEPARTMENT OF REVENUE SHALL RESULT IN A PENALTY OF $25.00 IN ADDITION TO ANY OTHER PENALTY IMPOSED BY THE REVENUE LAW OF FLORIDA. To be completed by the Clerk of the Circuit Court's Office Clerks Date Stamp This copy to Department of Revenue O. R. Book ? P ? ? I I and ?, , ? ? Page Number and File Number ????????? ???? I ? ? ? ? ? Date Recorded i-I / ?1 ?J Month Da Year This copy to Department of Revenue