Lind, Vera M
September 24, 1996
AFFIDAVIT
R,ECEIVED
STATE OF FLORIDA
COUNTY OF POLK
OCT 0 7 1996
crnr (GU~RK DEPT.
Whereas, the undersigned, are the Executors of The Last Will and Testament of May E. Lind, dated October 18, 1961, and
recorded in Official Record Book 399 Page 1047,
Whereas, the undersigned as Executors of the Estate of May E, Lind hereby grant to Vera M. Lind the right to be interred in Space
Three (3), Lot Thirteen (13), Block ~ven (7) at Clearwater Cemetery.
--Whereas, by-signingbclow;--the UflJ"bi/511"J acknowledge that they are the iawfut-txecutorsof tire Estate of May KT;indand
authorized to act as same.
Whereas, the undersigned agree to indemnifY and hold the City hannless from any and all claims, liabilities or damage arising from
the interment of Vera M. Lind.
In witness whereof, we have hereunto set our hand and seal this pnd day of
~dkj,.er
,1996.
SIGNATURES & ADDRESSES
PRINTED NAME & RELATIONSHIP
~~/7#~~
783. Lak Agnes Drive
Polk City, FL 33868-0742
~ SWORN TO and subscribed before me this Jlnd day of /J f~~ ,1996 by Edgar R. Lind. who is
persohally known to me or has made himself known to me by ~L l>rl~ LlI"!I.Jl6& (identification),
r SMlRNA MARTINEZ ., ~' m IlAIn..L;
(SEAL) NOTARY PUBLIC, STATl: OF FLOR'OA N ~ ~ " { ()
MY COMM!SSIO~~ D:PIRES JUNE 23,1987 otary ~ ::B, 1'7 fJ 7
\.../ /" ~Ml~~ Myw j0,""p'=' #.,.w..~~.iZ'fY""tir< 0>Jy
../ fL/~r:::-- Willard Lind Executor
Ed~ar R. Lind, Executor
Polk City, FL 33868-0742
'f. SWORN TO and subscribed before me this ;/1,1
personl1lly known to me or has made himself known to me by
(SEAL)
r
. SM'R~!A MARTINEZ
NOTARY FUCLlC STATE
MY COiv.I\\:SSION EXPIRES ~t:iORIDA
l COMM. , CO 2D6So1 23, 1997
day of (}('~bev, 1996 by WillardLind. who is
FI- "by. na /....l~-f' (identification).
~~,...
Notary ~
~ B- J9'77
My c mission expires: "o-/ttr);Ud SfJIl*,~ (!y;.y
.,
'.'
C' I T Y 0 F C LEA R W A T .E R
POST OFFICE Box 4748, CLEARWATER, FWRlDA 34618-4748 .
CllY HAll, 112 Sourn OSCEOlA AVENUE, C(J;ARWATER, FWRIDA 34616
TELEPHONE (813) 462-6684 FAX (813) 462-6488
DEPARTMENT Of mE
CilYCLERK
September 30, 1996
Mr. Edgar R. Lind
783 Lake Agnes Drive
Polk City, FL 33868-9742
Dear Mr. Lind;
Enclosed is an Affidavit which was approved by our Assistant City Attorney as suitable for
what you indicated you wanted to accomplish. Please complete the signature blocks which I have
indicated with a check mark and have a notary complete the notary blocks which I have indicated
with an x.
Upon receipt of the completed affidavit, our records will immediately be updated to reflect
the authorization you have given us to make the interment of your sister, Vera, when the time
comes.
It was a pleasure to speak with you on the phone last week. Please let me know if I may
provide further service(s) to you.
CITY CLERK DEPARTMENT
&~y~
Camille Motley
Central Records Specialist
*
"EQUAL EMPWYMENT AND AFFIRMATIVE ACTION EMPLOYER"