Rehbaum, Margaret CAFFIDAVIT
I, Margaret Sinclair Burkhart, the undersigned, do hereby attest that I'm the
descendant of Margaret C. Rehbaum, my grandmother, who is buried in Block 9, Lot
84, Space 4. Margaret C. Rehbaum was the owner of Block 9, Lot 84, Spaces 1
through 4, and Block 9, Lot 61, Spaces 1 through 4 (vacant) in the Clearwater Municipal
Cemetery.
Please take this affidavit as your authority to assign interment rights in Block 9,
Lot 61, space 1 to myself and in Block 9, Lot 61, space 2 to my husband, Joseph
James Burkhart.
We 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 as
stated above.
SIGNATURE
4 i6t/ /l(10 . " y.r, &"a,4
Margdret Sinclair Burkhart
Joseph James Burkhart
ADDRESS/PHONE
Pa?ilCi0I)ct 3V 7SS`
6,3
SWORN TO and subscribed before me this day of J ah U-0
c??lb by Margaret Sinclair Burkhart & J eph Jam Burkhart who rodu d
identification in the form of FI n C? Q,i and wh did/ id not
take an oath.
Notary Public
(?I S?? I&0 f?
My commission expires:
r?4?'r °ue?r Notary Public State of Florida
}}} Christine Robinson
o My Commission DD8181 15
Expires 08/27/2012