Gross, Miriam E
IN THE CITY OF CLEARWATER, COUNTY OF PINELLAS, STATE OF FLORIDA
TO:
CITY CLERK
CITY OF CLEARWATER
112 Osceola Avenue
Clearwater, Florida 34616
RE :
BURIAL PERMIT, MIRIAM E. GROSS
R F r "f Ql' r-: D
OCT 3 0 1991
CITY CLERK
SWORN AFFIDAVIT OF ARTHUR GROSS, HUSBAND
I ARTHUR GROSS, am a resident of the State of Florida and
reside at 280 Orange Street, Palm Harbor, Florida 34683 and hereby
state under oath as follows:
This is to advise the City Clerk of Clearwater that my loving
wife, Miriam E. Gross was the last surviving child of her father,
Edgar Beane.
Miriam E. Gross was born on November 10, 1911 in Agusta, Maine
of Edgar Beane and Golda (Ames) Beane. Miriam's mother, Golda died
two years later.
Edgar Beane married Edna M. Beane who raised my wife Miriam
as her mother. Edgar and Edna were close parents and in-laws.
On December 16, 1939, Edgar Beane purchased "South one-half
(S.~) Lot Seventeen (17) of Clearwater Cemetery Addition" as described
on the original deed~ Upon the death of Edna M. Beane, Edgar had her
buried in Block 7, Lot 17 Space 3. He had planned to be buried in
Space 4 next to his loving wife.
However, Edgar Beane later remarried Elizabeth Beane in
Haines City, Florida. Edgar Beane died in 1953 and is buried in
Haines City. At his funeral, his widow (now deceased) gave the
Clearwater Cemetery Deed to Edgar's daughter, Miriam (Beane) Gross,
my deceased wife., (Deed and Social Security Card are exhibits hereto).
On September 16, 1986, Miriam E. Gross contracted with the
National Cremation Society and completed their Pre-Arrangement Con-
tract wherein she certified that she was the daughter of Edgar Beane.
This certificate is hereby referenced as an exhibit hereto.
Based on the aforementioned information, I request that you
immediately issue a Burial Permit to put my loving wife, Miriam, to
rest and at peace. This has been a horrible experience on me emotion-
ally and physically.
If required, I can personally testify to the facts stated
herein as I know them to be true and correct.
Having appeared before me this October 30, 1991 and duly
sworn was Arthur Gross, personally known to me.
NOTARY PUBLIC
Notary PUbli~, State of Florida at Large
My CommissIOn Expires Dec. 15, 1991
,~~nded ~hru Agen(2:'S ". ry Brokerage
~~-,-;'<>', ~~
~~"'~;'--\
~
Arthur Gross
~
'~
<)
Q~s<'
-~
-'.. .-
~~
,~ ".
-
. .-...
-- : ~
....-
-">-, ...
(SEAL)
Exhibits: 3
~ .~
,-
(,
24 Octobvr. 1991
I .6ta:te. tha:ta.U. On the. .6iblin.R.6 to ml1 wi6 e. M.uu.am E. GJr.OM
pJr.e.-de.C.e.Me.d hvr.,M did hvr. 6a:thvr., EdRM Be.an.e.. Mu wi6e.
who pM.6 e.d away on. Octobvr. 21.6t ,u, to be. bwUe.d n.e.x.t to hvr.
'<:61.&p"'iiWthq,/t>:;~ fir1m.a. Be.an.e.. EdgaJt Be.an.e.WM bwUe.d -Ln.Ha,[n.e..6 TUu in. 1953.
.6ign.e.d
c~ ft,Anh
n.otaJty
No!cry PuMi(, $t(!~e of ~ id<<f
My Commission bpircs Se . 18, 1992
landed Thru Troy fain. I",uronce Ine.
RECEIVED
OCT 3 0 1991
CITY CLERK
4746 Mile Stretch Dnve
Holiday, FL :j4fi~O
81:~/937-4259