ACKNOWLEDGEMENT RECEIPT

To Whom It May Concern:

This is to certify that I have received the Original Owners Duplicate Copy under the name of City
of Candon with Title No. __________ in exchange of our lot (cemetery) this 30 th day of August , 2019.

This is to certify further that I am surrendering the title in the name of

___________________________ with Title No. ______________.

_________________________

_________________________ _________________________

Witness Witness