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7 n'
Paid by General Receipt No. ...... , , - , , , , Dated..QCtaber- -2 5...19.79.... .
List Price $ ... PQ..Q.Q...... Maximum No. Burial spaces ......2....
Discount $ ................. Total area In square feet ................
Net Paid $...200 .00 , , , , , , Monument permitted ... FUt............
RJR attached (Data above this line for City Record only)
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DEED #376
Edwin Loveless
613 SW Ellingsen Ave
Seba s ti an ,, Fl
LOTS 15 & 16 BLK 61-1 #Z•