HomeMy WebLinkAbout2284
c _
_
IN THS CIRCUIT COURT OF THE 19TH
` ~ JUDICIAL CIRCU2T, IN AND. FOR
SAINT LgCxE COUNTY, FLORIDA
cASS No. $ 0 9 3 C P
3*~! F?fi: T~tg $$TAT$ OF
FAME I. BRUHARER,
Deceased.
A F F I D A V I T
Before me, personally appeared LOGAN W. BRUBARER, being
.
duly sworn does say and depose the following:
1. That he i$-more than eighteen yeas (18) of age and
understands the obligation of an oath. .
2. That he is the surviving spouse of FAY I. BRUBARER, -
Deceased.
3. That there are no creditors to her Estate except
for the following medical expenses:
(a) Hodges Convelescent Aids: $ 299.00
(b) Dr. Joseph Moll: 334.00
(c) Dr. Marsicano: 800.00
(d) Martin County Nurses Association: 400.00
4. That all of the-foregoing medical bills and expenses
are to be gaid by Blue Cross-Blue Shield, or other provision
has been made for the payment of the same.
5. Funeral expenses, burial expenses, etc., have been
paid.
FURTHER AFFIANT SAYETH NAUGHT.
a~,~!~y? and subscribed
~~~~'~`~sie~tir~., on this ~ day ~ ~ .
o: ~'~AR s o
S _ s• key • ~i~' ~ 19 80 . S~~RI?~
: _ •~q~tEO
lei Q~ ssion Expires : 9 ~3~P~3
ao~~ r~~