Brantley, Shirley
INST # 98-268735
RUG 20, 1998 5:33PM
CEMETERY DEED
PINELLRS COUNTY FLR,
,,(, :r'1i ~ OFF .REC .8K 10.10 PG 19.1
THIS INDENTURE made thl, J? 'day of , 1998, between u.. ~ny [. .... . .
of Clearwater, Florida, a municipal corporation as G tor and I~"', whose
mailing address is 2606 N. Lincoln Ave.. Tamoa. FL 33607. County of Pinellas, State of
Florida, as Grantee:
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 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 zero zero (00), LOT One Hundred Eiahtv-Five (185).
BLOCK Fourteen (14), 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-Commissioner, by
its City Manager, and to be attested and its corporate seal affixed b the City Clerk on the day and year first above written.
STATE OF FLORIDA )
COUNTY OF PINELLAS)
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.
WITNESS my hand and official seal this ,g'f4- day of
Attest:
Susan Stephenson, Deputy C'
(1 L . /J ~ ~~,
~ Notary Public
y 1>tJ CAROLYN L~. ER,!NK
~ t,Jt.rlu.;:t .-," ;,' OJ
2 " ~ EXPIRES M:.'! 22,1999
~~ ~ BONCEDTHRU
'YJ1OF ~ ATWrnC BONDING CO..INC.
Before me, the undersigned, personally appeared Michael J. Roberto, 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 1.t:~bWDIf\J~ 9f' ..oj- ,1998.
~gg~ ULQ..O 7(jJ
REC ];. -ttl~
~. to form ~nd legal sufficiency: g;21S~:;' 5'0_ Print/type name:
~ ~ INT
John Carassas, Assistant City Attorney PIC
J CERT
:"'~ TO: City Clerk Department ~~~S ~ 1<--
P. O. Box 4748, clearwater:ortf.~4 r ~ U 0/1
~ ,1998.
(SEAl)
STATE OF FLORIDA )
COUNTY OF PINELLAS)
Print/type name:
~~
NO~jlry Public
..9.'( 1>tJ CAROLYN L BRtN~
43" If ..
2 ~ EXPIRES MAY 22,1999
~~!II! BONDED THRU
'lfQf "" AT\.ANT1C BONDING co.,lHC.
, .7"~O
Oocumentary Tax "d. e
Intantlble Tax Pd,
· ..... ty 9700-0026
~rl-' F. 08,B1, ker, Clerk. Pinelll8 ....un Rev. 7/97
8y -r D,eQutl CleG _
":;
FUNERAL ARRANGEMENT WORKSHEET
DATE OF DEATH
NO,
", C'-
First
~~ II, lifff
NAME
~:~
AGE-
Middle
~
1tA.~
Last
HOUR
lr:'~~
Arrangement Appointment-Day & Time:
OAt F.H, 0 At Residence' (Address):
Informant Interviewed by:
VITAL STATISTICS
City-Town
City-Town
Specify:
Din-Patient
D DOA
D ER
County
D None
Length of Illness
Apparent Cause of Death
Other Circumstances
Certifier of Death Certificate
Certifier's Address
Sex: [J..M'
BIRTHPLACE
Citizen: [D..\::tSA
Father's Name
DATE OF BIRTH
His Birthplace
Her Birthplace
MARITAL STATUS
Date & Place of Marriage
EMPLOYMENT STATUS: D Retired (Year
D Presently Employed
Kind of Business
Employer
Social Security No,
...
- Ct,,)
No, of Years
Highest Education
::!.
VETERAN:
~o
DYes
Branch of Service
Rank
Service Dates
to
Service No,
Honors-Commendations
INFORMANT'S NAME
Informant's Address
Informant's Phone