Stillwagon, DaleAFFIDAVIT
STATE OF FLORIDA)
COUNTY OF PINELLAS)
RECEIVED
MAR 2 5 2021
OFFICIAL RECORDS AND
LEGISLATIVE SRVCS DEPT.
I,-qLt i • -5 Fa moi`;: , the undersigned, do hereby attest that 1 m the
descendant of FL.4C i EN ST iLL 6,ON' , myGgricA-Er(AMD fAl ner of
Space(s) / / of Block 6 , Lot 2 3 in the Clearwater Municipal Cemetery.
Please take this affidavit as your authority to note the right to property described
above to myself. Per the City of Clearwater Rules and Restrictions the maximum
capacity of a space is two burials provided at least one person is cremated or two
cremated remains.
I 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
ADDRESS/PHONE
a -r, Pc-Topsi3r€2G, Pc,
'727—
i
WORN TO and subscribed before me this t 7 day of /VU
bye;�� j�e �s �lw�yv� . - who produced identification in the form of
ile-caet_a ,�.n24/,,,c 4and who dtt/did not take an oath.
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MY COMMISSION # GG 125413
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RE: Municipal Cemetery Inquiry - Stillwagon
LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Wed 11/18/2020 9:51 AM
To: Dale Stillwagon <dstillwagon@hotmail.com>
2 attachments (65 KB)
Block 6 Lot 23-Stillwagon.pdf; Affidavit -right to property.doc;
Good Morning Mr. Stillwagon,
See attached documentation that shows the burial status of Block 6, Lot 23. The Cemetery program shows that
Lucien Stillwagon was the owner of all spaces (1-12) in this plot.
Spaces 7 through 11 are indeed vacant and will be available pre -need to surviving descendants of the owner,
Lucien Stillwagon.
We just need an notarized affidavit stating that the deceased is a descendant/survivor of the owner and rights
will be granted. (See attached sample)
Note: Per the City of Clearwater Rules and Restrictions the maximum capacity of a space is two burials
provided at least one person is cremated or two cremated remains.
If you have any other questions please give me a call.
Thank You.
Judith LaCosse
StaffAssistant
ORLS Dept.
Phone: 727-562-4093
LaCosse, Judith
From: LaCosse, Judith
Sent: Wednesday, November 18, 2020 9:50 AM
To: Dale Stillwagon
Subject: RE: Municipal Cemetery Inquiry - Stillwagon
Attachments: Block 6 Lot 23-Stillwagon.pdf; Affidavit -right to property.doc
Importance: High
Good Morning Mr. Stillwagon,
See attached documentation that shows the burial status of Block 6, Lot 23. The Cemetery program shows that Lucien
Stillwagon was the owner of all spaces (1-12) in this plot.
Spaces 7 through 11 are indeed vacant and will be available pre -need to surviving descendants of the owner, Lucien
Stillwagon.
We just need an notarized affidavit stating that the deceased is a descendant/survivor of the owner and rights will be
granted. (See attached sample)
Note: Per the City of Clearwater Rules and Restrictions the maximum capacity of a space is two burials provided at least
one person is cremated or two cremated remains.
If you have any other questions please give me a call.
Thank You.
Judith LaCosse
StaffAssistant
ORLS Dept.
Phone: 727-562-4093
From: Dale Stillwagon <dstillwagon@hotmail.com>
Sent: Wednesday, November 18, 2020 12:35 AM
To: LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Subject: Municipal Cemetery Inquiry - Stillwagon
CAUTION: This email originated from outside of the City of Clearwater. Do not click links or open attachments unless you
recognize the sender and know the content is safe.
Dear Judith,
1
Per our conversation late Tuesday afternoon, I would like direction on the process of obtaining access or
establishing authorization for access to future occupancy of available unoccupied family cemetery spaces
described below in the Municipal Cemetery, preferably on a pre -need basis.
Lucien Stillwagon, who was my great-grandfather, purchased in the early 1920's or thereabouts what appears
to be twelve adjacent spaces currently described as Block 6, Lot 23, Spaces 1- 12. Lucien is interred in space 3
adjacent to his wife Clara in space 4, and his son Fred (my grandfather) in space 2. Other immediate family
members/descendants are interred in spaces 1, 5, and 12. I am not aware of the relation of the deceased in
space 6 to Lucien. According to the cemetery map, remaining spaces 7 - 11 are shown as unoccupied.
Next, I was able to locate an affidavit (copy attached) in the city's limited official public records (cemetery ->
folder "J" -> name: Jordan, Linda Kay) naming Lucien Stillwagon as owner of Block 6, Lot 23, space 6 and also
authorizing the interment of the cremated remains of Linda Kay Jordan in space 6 (subsequently disinterred
from space 6 and reinterred in space 5). One of the two remaining living grandchildren of Lucian at the time
who signed this affidavit, Dale Stillwagon Sr., was my father (and the son of Fred) and is now deceased. Reta
Stillwagon Jordan, the second signor and daughter of Fred, is now deceased as well.
Based on this information, I would like to get confirmation from official city records that those remaining
unoccupied spaces 7 - 11 in Lot 23 are indeed part of the original Stillwagon purchase including the currently
occupied spaces in the lot and if so, the procedure required to make those unoccupied spaces accessible pre -
need to surviving descendants of Lucien, or at the time when the need arises such as in the case of Linda K.
Jordan. My late relatives never informed me of the procedure to initiate access to any unoccupied family
spaces (such as for those that followed the interment of owner Lucian: Fred Stillwagon, Irene Dort, May I.
Dort, Linda K. Jordan; or for any living pre -need arrangements) nor provided any documents to show
ownership of designated unoccupied family spaces.
On a final note, I also didn't see any provision for this specific situation in reviewing online availability of City
Code Chapter 11- CEMETERIES, sec. 11.02 (6), so I must make a presumption that any of the unoccupied
family spaces were intended for the benefit of that owner's descendants, if any, such as those referenced in
the preceding paragraph.
Thank you for your assistance and guidance.
Regards,
Dale L. Stillwagon, Jr.
dstillwagon@hotmail.com
2
AFFIDAVIT
STATE OF FLORIDA)
COUNTY OF PINELLAS)
I, , the undersigned, do hereby attest that I am the
descendant of , my , owner of
Space(s) of Block _, Lot _ in the Clearwater Municipal Cemetery.
Please take this affidavit as your authority to note the right to property described
above to myself. Per the City of Clearwater Rules and Restrictions the maximum
capacity of a space is two burials provided at least one person is cremated or two
cremated remains.
I 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 ADDRESS/PHONE
SWORN TO and subscribed before me this day of ,
by who produced identification in the form of
and who did/did not take an oath.
Notary Public
My commission expires:
INTERMENTS
BURIAL
SP TYPE
1 FULL
2 FULL
3 FULL
4 FULL
5 URN
DECL
DORT
STILLWAGON
STILLWAGON
STILLWAGON
JORDAN
6 INFANT MONGER
12 INFANT DORT
12 INFANT DORT
DISINTERMENTS
REINTERMENTS
BURIAL DECL
SP TYPE
5 URN JORDAN
Status of Block: 6 LOT: 23 as of 11/18/2020
DECF DECM BIRTH DEATH INTERRED PERMIT
MAY
FRED L
LUCIEN A
CLARA A
LINDA K
UNKNOW
N
IRENE
ROBERT
5/15/1917 1/28/1977 1/31/1977
12/19/1887 12/22/1969 12/24/1969
1/1/1855 1/1/1924 1/1/1924
1/1/1860 1/1/1923 1/1/1923
7/11/1951 5/18/2000 9/24/2001
1/1/1935 1/1/1935 1/1/1935
1/1/1949 1/1/1949 1/1/1949
1/1/1901 1/1/1949 1/1/1949
DECF DECM BIRTH DEATH
LINDA K 7/11/1951 5/18/2000
INTERRED
6/21/2000
1186
738
2488
2487
2486
0
0
0
INFAr.r.S
Son of F. F. I;:ons er
---- I•M.1z:.ROB;RT . DORT
1949
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rel (' r,1/ /
_►�01 23
1.7 -r1 3 - S -/u •.2.1.zt;
rynerirr-el Y,20,="1
Lucien A. Sti l lwagon
• 1860 - 1923
C a - Stilllwas, on /
V
J.
Fred. Stillwagon
(.4 -12 -Wt -69
z -
MAY IRENE DORT
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