Hill, Molly Southard
e.
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AFFIDAVIT
WE, Karen Leggett, granddaughter, Virginia Randolph and Barbara Wheeler,
daughters, of MOLLY HILL formerly known as Molly Southard, who is the owner of Block 14,
Lot 532, Space 3 and the widow of Llewellyn Southard who is buried in Block 14, Lot 532,
Space 2 hereby provide this affidavit to attest to the fact that Molly Hill is Molly Southard and
to act as our authority to inter MOLLY SOUTHARD HILL in Block 14, Lot 532, Space 3 when
the need arises.
WE 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 MOLLY SOUTHARD HILL.
Address/Phone
;)705
Lorqo,
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(7d, 7)
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v~ndoIPh, daug ter
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Barbara Wheeler, daughter
BEFORE ME, the undersigned, personally appeared Karen Leggett on
, 2001, who executed the foregoing instrument and acknowledged the
xecution thereof to be their ~ i:\ct and deed for the use and purposes herein set forth, and
who has produced a ,1 . as means of identification or is personally
known to me.
WITNESS my hand and official seal this
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BEFOR ME, the undersigned, personally appeared Virginia Randolph on
, 2001 , who executed the foregoing instrument and acknowledged the
e cution thereof to be their , Z. and deed for the use and purposes herein set forth, and
ho has produced a { , . as means of identification or is personally
known to me.
WITNESS my hand and official seal this
\
BEFORE ME, the undersigned, personally appeared Barbara Wheeler on
, 2001 , who executed the foregoing instrument and acknowledged the
e cution thereof to be thei~a7ct and deed for the use and purposes herein set forth, and
o has produced a ~ as means of identification or is personally
known to me. f
WITNESS my hand and official seal this I
Print/type name