Sanders, Frank A
October 24, 1991
AFFIDAVIT
STATE OF FLORIDA )
COUNTY OF PINELLAS )
I,~Rex T. Sanders, the undersigned, do hereby attest that Frank A. Sanders
and I are the descendants, sole survivors and heirs of Doris H. Sanders,
deceased, who is buried in Block 15, Lot 15, Space C, Clearwater Cemetery.
I relinquish any right, title, and interest in the cemetery property
formerly owned by James A. Sanders,' deceased, described as Block 15, Lot 15,
Space D, Clearwater Cemetery.
I further agree to release, indemnify and hold the City of Clearwater
harmless from liability in the event of any claim arising from the use of the
above described property for the interment of Frank A. Sanders.
~' . ._~~NA~~ ~~
Rex r1nders
,18515 92nd Terrace N.
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" Seml no 1 e, FL 34647
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WITNESSES:
SIGNATURE
ADDRESS
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I). SWORN TO AND SUBSCRIBED be e me on th i s ~ V ~ day
of . ~~ , 1991, in Pinellas County, State of Florida.
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My commission expires:
~~otary' Pu})I~,.. ~ta'~l: ..H (.vLiUa
My Commission Expires April 20, 1993
Bonded Thru Troy Fain - Insurance Inc.
(SEAL)
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C I T Y
OF
CLEARWATER
pas T 0 F Fie E BOX 4748
C LEA R W ATE R, F LOR IDA 3 4 6 1 8. 4 7 4 8
, May 17, 1991
Mr. Rex T. Sanders
8515 92nd Terrace N.
Seminole, FL 34647
Dear Mr. Sanders;
Enclosed is an affidavit which states that you and your brother Frank A. Sanders
are the sole heirs to Doris H. Sanders, deceased who is buried in Space C, Lot
15, Block 15 of Clearwater Cemetery. Please have your signature witnessed (2
witnesses) and notarized and return to us.
In addition to this completed affidavit, we will need a copy of Frank1s birth
certificate. Because your father, James A. Sanders, now deceased and buried in
the state of Georgia, had remarried, we will also need the completed affadavit
from his second wife stating that she relinquishes all right, title, and interest
in the remaining cemetery space described as Space D, Lot 15, Block 15,
Clearwater Cemetery. We have sent the affidavit to Mrs. Cathleen Worth, 1114
Opel Avenue, Columbus, GA 31907 for fowrarding to Mrs. Eva Sanders as you
requested.
Sincerely,
J~jk~
Susan Stephenson
Document & Records Supervisor
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U.UAL RE.IDI:IfCE 01': MOTHI:R
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, NAME OF /1.1 I, ~ 'IN CITY LIMITS
10. CITY OR TOWN /C I---c Ll.,"''''--'' , 8 0 NO
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17. OCCuPATlori':;:0'j1tL.b-;< " '""2t''l/ ,~~jlL_ C (', 22. OCCUPATION "z~:;/r( Lc
NUMBER OF -:z. I NUMBER OF NUMBER OF
23. ~1~'t,~r~~DREN ~ .-J. 24. ~r~.;: _c~6~~~~J'ORN 0 25. ~'fJ:~i's~WgNorGE 0
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LOCAL REGISTRAR'S
SIGNATURE
GEORGIA DEPARTMENT 0
DIVISION OF VITAL RECO
DATE
FILED
SEP 10 '95&
MILITIA
DISTRICT'
LIVE BIRTH
DEPARTMENT OF HEALTH. EDUCATION, AND
WELFARE
ADM-S.1 U. S. PUBLIC HEALTH 8ERVICE
'Ibis is to certify that this is a true and correct copy of
,the certificate filed with the Vital Records Service, Georgia
Depar:t::rrent of Human Resources. TIlls certified copy is issued
under the authority of O1apter 31-10, Vital Records, Code of
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State Vital Records
Registrar and Custodian
Director, Vital Records
Service '
County . "..i.. ,..... /)'.
Custodian. ~ -a Cd, () ()~ ./'0 ~
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Issuro Bye) ~CJkLoAr
Date MAY 2 0 1991
(Void withotlt original signature
and impressed seal)