Ceraolo, Ila Mae
TH I S I NDENTURE Made th i s f! # day of,
n~-between the City of Clearwater, Florida, a munl al corpo~ ion created and
--existing under the laws of the State of Florida, party of the first part and
-;SIla Mae Ceraolo, whose mai~ing address is 135? S. Fort Harrison Avenue,
. HL n -Clearwater of the County of Plnellas State of Florlda party of the second part;
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PINELLAS COUNTY FLA.
INST :11: 90,-008341-
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CEMETERY DEED
*** OFFICIAL RECORDS ***
BOOK 7172 PAGE 1494
~
, 1990
III
urAL (oS6, WITNESSETH: That the said party of the first part, for and in
-----1-consideration of the sum of $100.00, to it in hand paid by the said party of the
second part, the receipt whereof is hereby acknowledged, has remised released
and quit-claimed, unto the said party of the second part, and her heirs forever,
all the right, title and interest, which the said party of the first part has
in and to the following described parcel of land, lying and being in Pinellas
County, State of Florida to wit: Lot 8, Block 14, Clearwater Cemetery, as
recorded in Plat Book 60 Page 30 Public Records of Pinellas County, Florida.
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This conveyance is subject to the condition that Grantee herein shall
not assign or convey said property without the written consent of the Grantor,
and to the further condition that said property shall be used only for cemetery
purposes as human burial sites and is also subject to such other rules and
regulations the City of Clearwater may adopt pertaining to use of said described
property.
TO HAVE AND TO HOLD the same to the only proper use, benefit, and behoof
of the said party of the second part her heirs and assigns forever.
IN WITNESS WHEREOF, said City of Clearwater, a municipal corporation, has
caused these presents to be executed in its name by; its Mayor Commissioner, by
its City Manager, and to be attested and its corporate seal affixed by the City
Clerk on this the day and year first above written.
Delivered
. CI~F CLEARWATER, FLORIDA
By -a7 &----
Ron H. Rabun, City Manager
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Approved as to form and correctness:
~{,
City Attorney
State of Florida,
County of Pinellas:
Personally appeared before me Rita Garvey, Ron H. Rabun, and Cynthia E.
Goudeau to me well known to be the persons who executed the foregoing instrument
of conveyance in the capacity of Mayor Commissioner, City Manager, City Clerk
respectively, and they severally acknowledged that they executed said instrument
in their respective capacity by and on behalf of and as the free act and deed
of the City of Clearwater, Florida a municipal corporation, for the uses and
purposes therein expressed.
oyt witne~Y. hand and official
() day of Uu17' 1990.
_/
Docurn~r1t~ry T,,~: rd." .. ,':>..'>---"--
seal at Clearwater,
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By ____.____._____.
!. r,!I'! r:!ork
This instrument was prepared by:
M, A. Ga 1 bra ith, Jr, __ /
City of Clearwater, ~~O;eox 4748
Clear.water,_.[lorida 34618
KARLEEN F. DEBLAKER, CLERK
JAN 10, 1990 3:31PM
--, ~
Rhodes!
& Wice, RA.
Funeral Directors
J. S. Rhodes "'
John H. Wice
January 2, 1990
P.o. BOX 895
CLEARWATER, FLORIDA 33517
TO: City of Clearwater
FROM: Ila Mae Ceraolo
1359 S. Ft. Harrison Ave.
Clearwater, FL 34616
I, Ila Mae Ceraolo, the only surviving child and immediate
next of kin, hereby authorize the disinterment and re-interment
of my mother, Ruth Marie Sundin, in Clearwater Cemetery, by
Rhodes & Wice, P.A., Funeral Directors or their designated agents.
All expenses of this relocation will be the responsibility of
Frances C. Leandri.
SIGNED:~~d k~JL rf~
Ila Mae Ceraolo
WITNESSq, ~ V' '} ~
C~ ~
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DRUID CHAPEl
800 EAST DRUID ROAD
18131 446-3055
D'Ust JOO-
BELCHER CHAPEl
830 NORTH BELCHER ROAD
(813) 446-2222
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32e.
321.
HRS Form 512,
Jan. 89 (Obsoleles
Previous Editions)
LOOAL FILl NO,
1. DECEDENT'S NAME (Firsl, Middle, Lasl)
C:;ERTlFICATE OF DEATH
'"', . FLORIDA
7.
Februar 6 1910 Indiana lis, Indiana
9a. PLACE OF DEATH (a..ck only one: see inSlruclions on OIher Side)
HOSPITAL: ~npalienl 0 ER/Oulpatient 0 DCA OTHER: 0 Nursing Home 0 Residence DOlher (Speci/y)
9c. FACILITY NAME (II nOl inslilullon, give Slreel and number) 9d. CITY, TOWN, OR LOCATION OF DEATH
2. SEX
Rose
;J. DATE OF DEATH (Montll, Day. Illar)
Januar 1 1990
8. DATE OF BIRTH (Monlll, Day; Illar)
Palomino
NUMBER Sa. AGE.Last Birthday
(ysarsl9
263-22-3584 7
7. BIRTHPLACE (City end Slale or Foreign Country)
Female
5b. UNDER 1 YEAR
Months Days
5c. DER 1 Day
Hours Minutes
8. WAS DECEDENT EVER IN U.S
ARMED FORCES? (Ills or No)
No
9b. INSIDE CITY LIMITS? (llls or ~
Yes
ge. COUNTY OF DEATH
9a.
9bde.
10. GIVE KIND OF
WORK DONE
DURING MOST
OF WORKING
LIFE. DO NOT
USE RETIRED.
Clearwater Pinellas
11. MARITAL STATUS -Married, 12. SURVIVING SPOUSE (II wile, give meiden name)
Never Married, Widowed,
Divorced (Speci/y)
Retail roduce Widowed
13b. COUNTY 13e. CITY, TOWN, OR LOCATION
lOa. DECEDENT'S USUAL OCCUPATION
Pro rietor
13a, RESIDENCE - SlATE
13.
13d. STREElAND NUMBER
Florida
13e, INSIDE CITY
LIMITS? (llIs or No)
Pine11as Clearwater
131. ZIP CODE 14. WAS DECEDENT OF HISPANIC OR HAITIAN ORIGIN?
(Speci/y No or lI>s - 1f)'N. speciIJ.i-!ailian, Cuben,
Mexiean, Puerto Rican. etc.) ~o 0 Yes
Speci/y:
2707 Morningside Dr.
15. RACE - American Indian, 16. DECEDENT'S EDUCATION
Black, While, elc. (Speci/y only highesl grade complelE
Speci/y:
Part
la.
28 CASE REPORTED
TO MEDICAL
EXAMINER?
(Ills or No)
No
ElemenlarylSEconda'1
(0.12) 1u
'Maiden Surname}
CoIIegE(1.4015 +)
Whit
Ceraolo
18. ~'S NAME (FiIa/,.
I ' ','It,
Rosa Versaggi
19b. MAILING ADDRESS (Slreet and Number or Rural Roule Number. City or Town, Slale, Zip Code)
Frances C. Leandri
208. METHOD OF DISPOSITION
1798 Lon Bow Lane Clearwater, FL 34624
2Ob. PLACE OF DISPOSITION (Name 01 cemelery. crematory. or 2Oc. LOCATION Cily or Town, Slata
oilier place)
o Cremation 0 Removal 'rom Slale
Clearwater Cemeter
21b. LICENSE NUMBER 21c. NAME AND ADDRESS OF FACILITY
(01 Licensee)
Clearwater, Florida
/7l/3
Rhodes & Wice, P.A., Funeral Directors
800 East Druid Ave. Clearwater FL 3461
te an~e and due 10 the
a: 238. On Ihe basis 01 examination and/or investigation, in my opinion death occurred a
~ the time, date and place and due 10 the cause(s) and manner as stated.
'i ~ S nalurw and Title ~
l~ 2311. DATE SIGNED (Mo.. Day. Yr.) 23e. HOUR OF DEATH
EW
8~
110 23d. PRONOUNCED DEAD (Mo., Day. Yr.) 238. PRONOUNCED DEAD (Hour)
02~
R (PHYSICIAN, MEDICAl EXAMINER) (7Ype or Prinl)
Street Ste. 206-S, St. PeterSburg, FL 33709
25b. LOCAL REGISTRAR - SIGNATURE 25e. DATE REGISTERED
~
26. PART. . E ler the diseases, injuries, or complications that eaused the death. 00 not enter the mode ot dying, suCh as cardiae or respiralory arrest, shock, or heart
lai reo LiSI only one cause on each line.
Approximale Inlerval
Between Onsel and
Death
Part II
Sequenlially list conditions,
if any, leading 10 immediate
cause. Enler UNDERLYING
CAUSE (Disease or injury
thaI inilialed evenls
resulting In death) LAST.
Intracerebral Hemorrhage
a.
DUE TO (OR AS A CONSEQUENCE OF):
Hypertension
b.
DUE TO (OR AS A CONSEQUENCE OF):
C.
DUE TO (OR AS A CONSEQUENCE OF):
d.
PART II. Other signilicant condilions contributing to death but nOl resulting in the
underlying cause given in Part I.
27a. WAS AN AUTOPSY
PERFORMED?
(Yes or No)
27b. WERE AUTOPSY FINDINGS
AVAILABLE PRIOR TO COMPLETION
OF CAUSE OF DEATH? (Yes or No)
29. IF FEMALE, WAS THERE A
PREGNANCY IN THE PAST
3 MONTHS? 0 YES 0 :!to
31. PROBABLE MANNER OF
DEATH
No
3Oa. IF SURGERY IS MENTIONED IN PART I or II ENTER CONDITION FOR WHICH IT wAS PERFORMED.
3Ob. DATE OF SURGERY (Mo., Day. Year)
32a. DATE OF INJURY
(Monlh, Day. Ill..r)
32b. TIME OF
INJURY
32c. INJURY AT WORK?
(Yes or No)
32d. DESCRIBE HOW INJURY OCCURRED
(Speeily) Accident, suicide or
homiCide; or undetermined.
M
32e. PLACE OF INJURY - AI home, larm,
atreet, laC1ory, etc. (Spaci/y)
321. LOCATION (Slreet and Number or Rural Roule Number. Cilyor Town, Slale)