Haviland, Barbarar
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OFFICIAL RECORDS AND
LEGISLATIVE SERVICES
September 4, 2003
Mrs. Barbara Haviland
6950 46th Avenue N., # 51
St. Petersburg, FL 33709
CITY OF CLEARWATER
POST OFFICE BOX 4748, CLEARWATER, FLORIDA 33758-4748
CITY MALL, 112 SOUTH OSCEOLA AVENUE, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562-4090 FAx (727) 562-4086
Re: Clearwater Municpal Cemetery
Dear Mrs. Haviland:
Our records indicate that Janet Clark Haviland, deceased, owns Block 7, Lot 147, Space 3 in the
Clearwater Municipal Cemetery.
I am enclosing an Affidavit granting interment rights to you and your husband based on information
from you that your husband, Edgar Clark Haviland is the sole surviving son of Janet Clark Haviland.
Please sign the form, have it notarized, and return it to me with a copy of the Power of Attorney that
you have.
If you have any questions, please contact me at 727/562-4097.
Sincerely,
n j?
Susan Stephenson
Document & Records Supervisor
As
Encl.
BRIAN J. At'NGST, MAYOR-COiMMISSIONEK
HOYT HAMILTON, VICE MAYOR-COMMISSK)NER WHrimy GRAY, COMMISSIONER
FRANK HIBBARD, COMMISSIONER ® Bi . (ONSON, COMMISSIONER
"EQUAL EMPLOYMENT AND AFFIRMATIVE ACTION EMPLOYER"
September 4, 2003
AFFIDAVIT
I, Barbara Haviland, having Power of Attorney for Edgar Clark Haviland (copy
attached), sole surviving son of Janet Haviland a/ka Janet Clark Haviland, do hereby
attest that he is the sole surviving heir of Janet Haviland, deceased, who is the owner of
Block 7, Lot 147, Space 3 in the Clearwater Municipal Cemetery.
Please take this affidavit as authority to grant interment rights for my husband,
Edgar Clark Haviland and myself, Barbara Haviland in Block 7 Lot 147, Space 3. We
understand that the maximum capacity of a space is two burials provided at least one
person is cremated.
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 the above named individuals.
SIGNATURE/ ADDRESS/PHONE
Barbara Haviland
BEFORE ME, the undersigned, personally appeared Barbar Haviland on
2003, who executed the foregoing instrument and
acknowledged the execution thereof to be her free act and deed for the use and
purposes herein set forth, and who has produced a
means of identification or is personally known to me.
as
Notary Signature (Printed Name)
CITY OF C LEARWATE R
POST OFFICE BOX 4748, CLEARWATER, FLORIDA 33758-4748
Yom' CITY HALL, 112 SOUTH OSCEOLA AVENUE, CLEARWATER, FLORIDA 33756
.{ TELEPHONE (727) 562-4090 FAx (727) 562-4086
DEPARTMENT OF THE
CITY CLERK
April 29, 2002
Mrs. Barbara Haviland
6950 4611' Avenue N., #51
St. Petersburg, FL 33709
Re: Clearwater Municpal Cemetery '
Dear Mrs. Haviland:
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Our records indicate that Janet Clark Haviland, deceased, owns Block 7, Lot 147, Space 3 in the
Clearwater Municipal Cemetery.
I am enclosing an Affidavit granting interment rights to you and your husband based on information
from you that your husband, Edgar Clark Haviland is the sole surviving son of Janet Clark Haviland.
Please sign the form, have it notarized, and return it to me with a copy of the Power of Attorney that
you have.
If you have any questions, please contact me at 727/562-4097.
Sincerely,
Susan Stephenson
Document & Records Supervisor
/SS
Encl.
"EQUAL EMPLOYMENT AND AFFIRMATIVE ACTION EMPLOYER"
April 26, 2002
AFFIDAVIT
I, Barbara Haviland, having Power of Attorney for Edgar Clark Haviland
(copy attached), sole surviving son of Janet Haviland a/ka Janet Clark Haviland, do
hereby attest that he is the sole surviving heir of Janet Haviland, deceased, who is
the owner of Block 7, Lot 147, Space 3 in the Clearwater Municipal Cemetery.
Please take this affidavit as authority to grant interment rights for my
husband, Edgar Clark Haviland and myself, Barbara Haviland in Block 7 Lot 147,
Space 3. We understand that the maximum capacity of a space is two burials
provided at least one person is cremated.
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 the above named individuals.
SIGNATURE/
Barbara Haviland
ADDRESS/PHONE
BEFORE ME, the undersigned, personally appeared BarbaLHaviland on
2002, who executed the foregoing instrument and
acknowledged the execution thereof to be her free act and deed for the use and
purposes herein set forth, and who has produced a
means of identification or is personally known to me.
as
Notary Signature (Printed Name)
CEMETERY SEARCH NAMES AND NOTES REQUEST
FOUND AS CURRENT OWNER OF BLOCK: 7 LOT: 147 SPACE: 3
OWNER 1: JANET C HAVILAND
DECEASED NAME: EDGAR E HAVILAND
BLOCK: 7 LOT: 147 SPACE: 1
BORN: 01/24/1885 DIED: 11/20/1940 INTERRED: 11/20/1940
INTERMENT NOTES:
DECEASED NAME: HAROLD J HAVILAND
BLOCK: 5 LOT: 15 SPACE: 8
BORN: 04/27/1914 DIED: 08/27/1990 INTERRED: 08/30/1990
INTERMENT NOTES:
DECEASED NAME: WILHEMINA HAVILAND
BLOCK: 7 LOT: 147 SPACE: 4
BORN: 02/15/1920 DIED: 03/10/1958 INTERRED: 03/11/1958
INTERMENT NOTES:
1
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