Collins, Mary E
.
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C IT Y
OF
CLEARWATER
POST OFFICE BOX 4748
C LEA R W ATE R, F LOR I D A 33518 - 4748
August 21. 1987
HRS/ Adult Payment/ Unit 95
23 E. Tarpon Avenue
Tarpon Springs, FI 33589
Re: Mary E. Collins
To Whom it may concern:
In response to your second inquiry regarding Mary E. Collins, with the
additional information given in the enclosed letter I can confirm that Mrs. E.
W. Collins, owns a plot in the Clearwater Cemetery with four spaces. Ernest
W. Collins is buried in one space leaving three spaces available spaces in
Block 8 Lot 52.
However our records do not indicate Mary E. Collins as owner.
I regret I could not be of more assistance to you. I have enclosed all the
information pertaining to your client that was forwarded to me.
If I can be of further help feel free to contact me.
Sin/relY,
"-!JtlA,.f~EH,( n/
ISarah Brown, Acting Public
Information Supervisor
"Equal Employment and Affirmative Action Employer"
.'
ml rJB'~i~'r~II~~~"OF HEALTH AND RFHABIIJ~;'\TI~'E SERVICE....
DISTRICT rIVE
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Date:
JUt ~ 1 19~"
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Re:
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Gentlemen:
The above mentioned individual has applied for assistance with the
State of Florida. Therefore, it is necessary for us to investigate
all possible resources. Please try to respond to this inquiry with-
in ten days because we cannot determine eligibility without this
information. Your cooperation in this matter is greatly appreciated.
Return Address:
~RS I ADULT PAYMENTS I UNIT 95
23 E. Tarpon Avenue
Taipon Springs, FL 33589
Sincerely,
. ---;:r<c.{ ..cf:.! . -T;;.-~--
_) .' (/ . / ----..' r
- \~x/ . I I 7 ,~)~{.,L'L.-~'-C~
Public Assistance~Efigibilit~ Specialist
Unit '1~\ ~ \
Please answer the items circled below:
/~ 1.( .~~ Legal description of the plot (s)
.~---/ '-'-
(
,_B. Name(s) on deed (Owners)
,/-
. C. Can the plot be sold with the signature of just one owner?
"---'
/--
D. How many spaces are owned by the applicant and spouse?
~,
Are the unoccupied plots saleable? Yes No
\ E.
.,?=--
( F.
',-----
How many are unoccupied:
1. Spaces
2. Crypts
3. Vaults
0'A.
'''-,
G. Current market value of each
unoccupied space:
1. Spaces $
2. Crypts $
3. Vaults $
Are there any uninscribed headstones, plaques, monuments, or
other markers on the applicant's plots?
What is the current market value of all uninscribed markers?
$
B.
Cemetery Official's Signature
1
~'-
.0
STATE OF FLORIDA
ESTADO DE LA FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
DEPART MENTO DE SALUD Y SERVICIOS DE REHABILITACION
FINANCIAL/MEDICAL RELEASE
AUTORIZACION PARA INFORME MEDICOjECONOMICO
DATE (FECHA):
7 /0,3 /~7
TO WHOM IT MAY CONCERN:
A QUIEN PUEDA INTERESAR:
~
I hereby grant permission and authorize any bank, building association, employer,
insurance company, real estate company, or any financial institution of any kind or
character to disclose to any accredited agent of the Department of Health and
Rehabilitative Services full information as to my past, present or future bank
accounts, earnings, insurance policies or property.
Por la presente autorizo a cua~ier banco, asociaci5n constructora, companta de
seguros, compan{a de bienes ra~ces, 0 instituci5n financiera de cualquier clase, a
suministrar a cualquier agente acreditado del Departmento de Salud y Servicios de
Rehabilitaci5n, informaci6n completa sobre mis pasadas, presentes y futuras cuentas
bancarias, ingresos, p~lizas de seguro 0 propiedades.
~
I also authorize the release of any medical and/or psychiatric information to the
Department of Health and Rehabilitative Services.
Igualmente autortzo el suministro de cuaZquier informaci5n mtdica 0 siqui5.trica al
Departmento de SaZud y Servicios de Rehabilitaci5n.
This release is valid from
Esta autorizacitn es valida desde
to
hasta
Ih~ /tf7
, I'
Until rtevokAC!
Signature (FirmafX.. fie D
Name on Account
NUmero de la Cuenta
" ,
" C ,it..;.-vv-J
,
HRS-SES Form 2613, Dee 78 (Replaces DFS-AP-7521 which may be used)
(Stock Number: 5747-000-2613--3)
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CI T Y
OF
CLEARWATER
POST OFFICE BOX 4748
C LEA R W ATE R, F L 0 R-t D A 33518 - 4748
August 10, 1987
HRS/ Adult payment/ Unit 95
23 E. Tarpon Avenue
Tarpon Springs, Fl 33589
Re: Mary E. Collins
To Whom it may concern:
Our records does not show Mary E. Collins as an owner of property at City of
Clearwater Cemetery. As a doubt check I contacted Pinellas County Official
Records Office and records were checked back to 1957. The findings was the
samet no listing of ownership. If you wish to check the records prior to 1957
please feel free to contact the Pinellas County Official Records Departmentt
462-4876.
If I can be of further assistancet please do not hesitate to call.
Sincerely,
0tiAJ)); P-<Ar---
Sarah Brown; Act~ngPublic
Information Supervisor
'.
"f:qual f:mploympnt and Affirmativl' Action Employer"
"-
C IT Y
OF
CLEARWATER
POST OFFICE BOX 4748
CLEARWATER, FLORIDA 33518 - 4748
OFFICE OF THE CITY CLErK
November 15, 1985
"
Mary E. Collins ~urchased 4 spaces in the Clearwater
C~rn(-.tcry on February 6', 1950. 'T'he legal descript ion of
the property is Blk. 8, Lot 52. Ernest W. Collins is buriej
in the southernmost space. There are 3 spaces available
for burial in this block.
The current price of spaces avaiJable in the Clearwater'
Cemetery is t>200. 00. These spaces Here oripinally pUY'chas.:;d
for $40.00 per space. The City will repurchase these 3
remaining spaces for 85% of the original purchase price which
would be $34.00 per space.
If we can be of further assistance please contact us.
Clearwater Cemetery
City Clerk's Office
P. O. Box 4748
Clearwater, Fl 33518
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C I T Y
OF
CLEARWATER
POST OFFICE BOX 4748
CLEARWATER, FLORIDA 33516
OFFICE OF THE CITY CLERK
April 13, 1984
Mr. Robert K. Burgess
56 Sunset Circle
Imperial Terrace
Tavares, Fl. 32778
Dear Mr. Burgess:
Our records indicate Mrs. E. W. Collins purchased Block 8,
Lot 52. Clearwater Cemetery on February 6, 19~O. This lot
contains four burial spaces.
In order to sell two of the spaces we recommend a lawyer
be contacted to draw up a Quit Claim deed. Once drawn this
document should be recorded in the public record of Pinellas
County.
Although not required, this office would appreciate being
notified of the change in ownership when it occurs.
Very truly yours,
~:,,~ _L~
r -
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Lucille Williams, CMC
City Clerk
LW:ds
"Equal Employment and Affirmative Action Employer"
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RE:CElVED
FEB 27 1984
CiTY CLER~
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- Returrr-to: (enclose self-addressed stamped envelope) r
~~ Violet H. Kane
r
88203460
OR 6 8 , 5 PG 0 3 5 2
Addr...: 211 Broadway
Dunedin, Florida. 34698
This Instrument Prepared by: Kane Funeral Home
DUN" fOt
Addr...: 1006 N. Ft. Harrison Ave.
Clearwater, Florida. 34615
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SPACE ABOVE THIS LINE FOR PROCESSING DATA
. lhis 4l1uit-{laim Jttd, Executed this 10th day of
SPACE ABOVE THIS LINE FOR RECORDING DATA
August
, A. D, 19 88 ,by
first party, to
Robert K. Burgess, George E. B~rgess, and Marjorie L.
co
Nicho:fi
c::
GJ
h ff' dd . Violet H. Kane
w ose posto lee a ress lS .
211 Broadway
Dunedin, Florida.
34615
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second party:
(Whtr-ever used herein the terms 'Cfint 'party" and usecond party" shall include singular and plural, heirs, legal ~
reprc!entativt!:l, and assigns of individuals, and the successors and anig"s of co~porations, wherever the context
'0 admits or require..) W
N
~itntsstlh, Htat tlte said first parly, for and in consideralion of the sum of $ 350.00
in hand paid by tlte said second party, the receipt whereof is hereby acknowledged, does hereby remise, re-
lease and quit-claim unto the said second party forever, all tlte right, title. interest, claim and demand which
t'te said first party 'tas In and to the follOWing described lot. piece or parcel of land, situate, lying and being
in the County of Pinellas State of Florida , to-wit:
el attoPlM j
SIC (,. (''-t) <1
I>S ;( )- ~
m
fEES
IITr
Pic
lEV
Lot 52 (Fifty Two),Block 8 (Eight), 1st (First) and 2nd (Second)
Space South. (From the North).
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It ,'ti ,....,............ IntnMgihle Tax PI.
k. _~. . ,~' Clerk, Finelli\! Collntll
lIitp. ~. ~.. Dept,,, a1'lt
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1412,eS3SPB ,Oe-18~8
o 1 .OED~!UAGE5S
~CORDI* 1
DOC 5TAI'IP!. 2.
, 13:5&1 0
-
$&, 0
. Sa. 0
, . TOTAL 1
CASHA"T.TENDEAEDI
afANOE I
$8. 0
S8. 5
Se. 5
'tOtAL ~'.
'.
10 }taut and to Jtold the same together with all and singular the appurtenances thereunto
belonging or in anywise appertaining, and all the estate, right, IiIle, interest, lien, equity and claim what-
soever of the said first party, either in law or equity, to the only proper use, benefit and he hoof of the said
second party forever,
In liilIilntss liIhtrtof, The said first parly has Signed and sealed these presents the day and year
first above written, // ../
S~..aleJa'r6'.".J in .",..nce of, ---L~_:s:~_~_- _______ .
~~;.P/~~u: ...---.-----.---u~t.u-i~u:
~LMl.-~.uzk.L._________ ...,~uufJ,l~u---uu
ST ATE OF FLORIDA,
COUNTY OF P;i~el1as. \
}
" ~,~.' ,', I HEREBY CERTIFY that on this day, before me, an
ofJic~r' ~uly a~h:Sri~~d in the State aforesaid and in the Cou nty aforesaid to take acknowledgments, personally appeared
.: .~).' ,
'~obf>;r~)k; 'Bur,ge;;;s, MaMarjorie L. Nichols, George E. Burgess
. : to "I e._ khtiwu.' to .o('".:1hi' person described in and who execu ted the foregoing instrument and they acknowledged
'" ',' -", .
bcforto. /1le'1haf;fliey executed the same,
. . ,..' ~. ' ,.,' .' ~.
WITNESS my hand arid official seal in thc County and Si.hte last aforesaid this 8th __~. day of
.1'""., . '00 l:lNVHnSNI SH1NMO 01n\l ~'(,I>uue / ' ~1fY'
August A. D, 1988i6t 'E Jat1W;l:JOO saJld,] uOISqW...UIO~~If+, 1 _, ~;;j" 7 ,/;/ /' ,
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