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Swift, John Dale August 6, 1996 AFFIDAVIT STATE OF FLORIDA ) COUNTY OF PINELLAS ) I, the undersigned, do hereby attest that I am the decendant, sole survivor and heir of John Edward Swift, Sr., deceased, who is buried in Block Six (6), Lot Thirty-one (31), Space Eleven (11), Clearwater Cemetery. As heir to the interest and/or control in the above described cemetery space, I authorize placement of the cremated remains of my son, John Dale Swift, in that space (Block 6, lot 31, Space 11) with his grandfather, John Edward Swift, Sr., deceased. .' ----~ ---- -I;f'uitfler agree to refease,mderilliny and noldtlfe"ctty ofClearwaterhmmless-fronl liabHityiil1he event of any- claim arising from the use of the above described property for the interment of cremated remains of John Dale Swift. ,f) SIGNATURE ~ ~C:A,.~ ~. Edward Swift, Jr. 2218 Fox Chase Dnve, Condo A2 Hudson, FL~ 31(pf, Cf .. , ...i.~,.."j~":~ \'.'-~';;" :,:.. 'f:~ yo: WITNESSES: ~~~ 12218 Fox Chase Drive, Condo A2 Hudson, FL 6d HI" ..3'1669 PRINTED NAME & RELATIONSHIP Ardith Swift. Spouse SWORN TO and subscribed before me this ~. day of Swift, Jr. who is personally known to me or has made himself known to me by (identification) . (SEAL) ~ ~_/~ Notary Sharon L Rossler