Beck, Daniel LSTATE OF FLORIDA
COUNTY OF D q t./
AFFIDAVIT OF DANIEL L. BECK
I, Daniel L. Beck, the undersigned, to hereby attest that I and my brother, Robert W.
Beck, are the sole survivors and heirs of George D. Beck (deceased), who was the owner of
Block 5, Lot 11, Spaces 14, 15 and 16, Clearwater Cemetery.
Please take this affidavit as your authority to assign my interment rights in Spaces 15 and
16, Lot 11, Block 5, to my brother, Robert W. Beck.
I agree to release, indemnify and hold the City of Clearwater harmless from liability in
the event of any claim from the use of the above described property.
SI TU ADDRESS:
Daniel L. Beck
NY-"W-'f eT f v 1J 41 (- (-.e- fem.
35 z --- CS) 7
SWORN TO and subscribed before me this day of g .a , 2007,
by Daniel L. Beck, who is personally known to me or who has produced identification in the
form of F& b L 1310o- /7Z-9Z - y V S' -0 and who did/did not take an
oath.
otary Public
(Print or type name)
My Commission expires:
PAUL D. MCARTHUR
2"? °OO MY COMMISSION #DD604227
EXPIRES: OCT 111 2010
E'RF Bonded through 1st state insurance
44 STATE OF FLORIDA)
COUNTY OF DUVAL)
AFFIDAVIT OF DANIEL L. BECK
I, Daniel L. Beck, the undersigned, do hereby attest that my brother, Robert W.
Beck, and I are the sole descendants of Robert H. Beck, our uncle, who is the owner of
Block 5, Lot 11, Spaces 5, 6 and 13, in the Clearwater Cemetery. He is buried in Space
5. Space 13 is vacant.
Please take this affidavit as your authority to assign rights to my brother, Robert
W. Beck, to Space 13 in Block 5, Lot 11.
I 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.
NATU .
Daniel L. Beck
ADDRESS:
DMIM L Back
4760 Margate Ddve
JaCksonvNe
32207
SWORN TO and subscribed before me this day of , 2011,
by Daniel L. Beck, who is personally known to me or who produced i entification in
the form of L J ,20o and who did/did not take an
oath.
Notary Public
(Print or type name)
My commission expires:
PAUL b. WAMUR
MY COMMISSION 4 EE 000478
* * EXPIRES: October 11, 2014
Bonded Thu Budyet N*q Services