Preston, Harold
,
MAY-04-1998 11:56
May 4, 1998
CL8=lRLJ:lTER CITY CLERK
813 562 4086
AFF'IDA VIT
STATE OF FLORIDA )
COUNTY OF PINELLAS )
I. the undeIsigned, do hereby attest that I am the Exewtrix of the Will of Ray Ii. Everett. deceased who
was the record 0WIlCI' of Space ODe, Two, Three and Pour (1,2,3,4), Lot Twenty-seven (27), Block Five (5) located
in the City ofCleanvat.crMunicipal Cemetery.
I, 8J'llIll riBht of intennel1t of cremated remains fM Harold Preston, ~ell!led. in space four (4)
and make known my desire to be interred in that same space.
I. grant right of intennent of a'enlated remains of H e r b e" + ~ V evctt...in space two (2).
I, grant right of interment ofcrcmaled remains of Do 0 h ~ in space one (1).
I, further agree to telcaso, indemnitY and hold the City of Clearwater hannless from liability in the event
many claim arising from the use of the above described property.
SIGNATURE
" ~~I"r;' L. fNi~
(and )
qq0 -r;f.,VN,<;e~rf kl'
NeuJ f/o.ve~1 a;, ObSI'L
WITNESSES:
SIGNATURE & ADDRESS
PRINTED NAME & RELATIONSHIP
(SEAL)
t{ day of MaL{ ,199Sby
~rsonal1y tnown to me or bas made
(~~
SWORN TO and subscribed before me this
G ev-a I elL tv ~ b .' f I"e8 to"'-J
himself known to me by 7)h~ J, ~
My cmmnission expires:
TOTAL P.002