Ulmer, Madge McQuaggeSTATE OF FLORIDA
COUNTY OF SARASOTA
AFFIDAVIT
I, Madge McQuagge Ulmer, the undersigned, do hereby attest that I and my
brother, Archie McQuagge, are the sole survivors and heirs of Laura McQuagge
(deceased), who was the owner of Block 7, Lot 97, Spaces 1, 2, 3, and-4. Clearwater
Cemetery.
Please take this affidavit as your authority to assign interments rights in Space 4,
Lot 97, Block 7 to me, Madge McQuagge Ulmer.
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 as
stated above.
SIGNATURE/ ADDRESS
7& -2 a 7 3 579 N ID fzA(d P--(
Madge M Quag U "r 5 -d/-, , e 3 kfz
SWORN TO and subscribed before me this / day of ,
200 5 by Madge McQuagge Ulmer who produced identification in the f rm of
11)E(1 KAJI LWA.) and w 'd/did not take an oath.
No
ary Public
1 R. SUE DANNELS
.' MY E PIRF SlON p CC845397 O?
X 1 July 1, 2007
'?E a F Bonded TY r; ? ,Public Underwriters
My qtnmission expits:
Nov+:?,.xn:,•