Woods, Lillie MaeRECEIVED
0 C T 1 1S93
CITY CLERK DEPT.
AFFIDAVIT
STATE OF FLO DA )
COUNTY OF e, LAS
I, the undersigned, Doris Woods Logan do hereby assign all right, title and interest I have in
cemetery property owned by Lillie Mae Woods aka May Woods, deceased, who is buried in Block 8,
Lot 25, Space 1 in the Clearwater Municipal Cemetery in Clearwater, Florida. Please take this letter as
your authority to reserve the two remaining spaces, described as Block 8, Lot 25, Spaces 3 and 4, to my
sister, Lucille Woods.
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 Lucille
Woods.
SIGNATURES
Doris Woods Logan
(Address)
J
RELATIONSHIP TO DECEASED
The foregoing instrument was acknowledged before me this 7 day of Q(?, 1993 , by Doris
Woods Logan who produced identification in the form of 'py,? L %&-d (? and who did/did
not take an oath.
ublic
JAMES J.4'
?. . Notary Publir
%rA
My c mmi.li
on wpires:
JAMES J. KI AUSW
(SEAL) Notary public, SIMS01p4 ida
my Comm• EON Sept 51 1995
No. CC141400