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38.3
<br /> �1t]tSC �E�,ILA�T���T� R�C ��� �t7
<br />� 21817—The Augustine Co., County Supplies, Grand Island, Nebr.
<br /> 5a. If married, widowed or divorced
<br /> H?J SBAT�tD o f
<br /> or
<br /> WIFE oP
<br /> 6. DATE OF BIRTH (mo. ) Dec. �day) 17 (year) 1�7�
<br /> 7. A�e Years Months Days If less than 1 day
<br /> 61 3 1� Hrs. . . or Min. . . . . . .
<br /> OCCUPATION
<br /> $. Tra.de, profession cr particula.r kind of work done, as spinner, sawyer, bookkeeper, etc.
<br /> P�ivate Sec 'y.
<br /> �� Industr.y or business in which ��rork �a�s done, as silk mill, saw mi11, bank, etc.--
<br /> Insurance �ffice.
<br /> 10. Date deceased last Taorked at t'riis occupation �month and year) ----
<br /> ]�„�.. Total ti �ears) spent in this occupation ---------
<br /> 12. Birthpla.ce City or To?an ---------
<br /> and.
<br /> State or Country Missouri
<br /> 13. Name of F�ther. . . Thomas �.Beach
<br /> 14. Birthplace City or ToT�n
<br /> of and .
<br /> Father State or Countx�y ---Vermont
<br /> 15. Maiden name of Mother ----Maria Ca,rmean
<br /> 16. Birthpl�ce City or Tot�n
<br /> of and
<br /> Mother Sta.tP or Co:antry . . . . . . . . . .
<br /> 1�. IIVFORMANT Mrs. W, J, Byer
<br /> (Address ) 1933 B. St. Lincoln, Nebr.
<br /> l�. BURIAL, CRFI�IATIOiV, or REMOVAL
<br /> Place Wyuka Date Apr. �, 19�+0
<br /> 19. UNDERTAKER Roberts Mortuary
<br /> (Add.ress) 1110 P. St. , Lincoln, Nebr.
<br /> 20. Filed Apr �, 19�0 M.F.Arnholt �
<br /> Re�istra.r.
<br /> M�'DTCAL CERTIFICATE OF DEATH
<br /> 21. DATE OF DEATH A�ril 5, 19�0.
<br /> 22. I HEREBY CERTIFY, That I attended deceased from May Z93� to April 5th 1940.
<br /> I l�.st saw her alive on April 5tn, 19�0, dea.tn is said to have occurred on
<br /> the date stated �'oove at 5 P. M.
<br /> �'he principal c�uGe of death and related causes of importance in order of onset wer. e
<br /> as fnllows:
<br /> Exau�tion & Malnutrition Date of Onset
<br /> r Important
<br /> Contributory causea of importance not related to �Physician:Underline the one ca��se
<br /> �rincipal cause: General 'carcinoma of wr�ole abdomen & chest. �a.bove to which de�th should be charged.
<br /> Name of oner�tion cleaned house Date of Operat. 1937
<br /> Wh�t test confirmed dia�nosis �n�as there an autopsy no
<br /> 2�. If death T��as due to exterr.a.l causes �violer�ce) Fill in a,lso the f�llo�aing:
<br /> Accident, suicide or homicide Date of . . . . . 19. . . . .
<br /> WhPre did in,jury occur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br /> ( Specify city or toTan, county and state)
<br /> Specify ��rhether in,�ury occurred in inc'�ustry, in home, or in public nlace. . . . . . . .
<br /> Manner of in,�ury . . . . . . . . . . .
<br /> Nature of in,jury . . . . . . . . . .
<br /> 24. Was disea.se or in�jury in �ny T�aa;� related to occunation of deceased . . . . . . . . . .
<br /> If so, specify . . . . . . . .
<br /> ( Signed) E.B. Finney M. D.
<br /> (Ada_res s) 323 So. 14th St.
<br /> L3.ncoln, Nebr. � �
<br /> I her�by certif y that this depa.rtmPnt has legal custody of birth and death certificates � �
<br /> and that the foregoing is a true copy of the original certificate of death of Mary Beaeh.
<br /> ( SEAL) Jean Barrett
<br /> State egistrar � � �
<br /> Lincoln, Nebra ska. May �, 19�0 � � �
<br /> Filed for record this l�th day of April, 19�F�+, at �: 30 o 'clock A.M.� �����
<br /> Register of D eds �' `
<br /> 0-:�- �-^-'J-0-0-0-7-0-0-�-0-0-0-0-0-0-0-^-�-7-�-0-C-0-0-0-0-'`�-�-,�-0-U-0-0-0-0-0-Q-�-0-0-0-0 �o�
<br /> ASSIGNMEN^1 OF REN�S �
<br /> 6 � �
<br /> KNOW ALL MEN BY THESE PRESENiS: Ralph A. Seott and Gertrude A. scott, Husband and Wife,
<br /> of the County of Hall, State of Nebraska, for and in consideration of the sum of �10, 000.00
<br /> Ten lhousand and No/1�J0 Doll�rs, as a loan in hand pa.id to Ralph A. Scott by '�he Equitable . .
<br /> Building and Lo�n Asaociation, of Grand IGland, Nebraska, a corporation, and other good and ,� �
<br /> naluable considerations, the receipt TtiThereof is herPpy ackno?aledged, do hereby assign, tra_ns •� � �
<br /> Per and set over to said Association, as collateral security for the duration of the loan, � '�
<br /> all the rents, income, and �rofits accruing upon the following descri�aed property, situated �
<br /> in the County of Hall, State of Nebrask�., to-tait: 4
<br /> Lot Ei�;ht (�) in Block Sixty-Ei�ht (6�) in the �rigina.l To?,�n, no�a �ity of Grand I51and,
<br /> �e �
<br /> Nebraska, as surveyed, platted and recerded.
<br /> And ?ae hereby authorize and empower The Equitable �uildin� ar�d Loan Associatic�n, of ,
<br /> Gra.nd Island, PJebraska, its authori�ed agent� and at�orneys, to act for us and rent the above
<br /> described �remises, and in our b1a.cP collect and receipt for said rent, at such t�rices and
<br /> - upon such terms as it may see fit. �� is Purther ex�ressly stipulated that, if the assign8rs,
<br /> or tneir successors, occupy said. premises durin the existence of said loan tne Assi nee �
<br /> g , g
<br /> �hha 11 h��v t h s am r
<br /> e e e i hts of for it r
<br /> fe u e e ectment for forcible ntr nd d i r
<br /> e a eta ne
<br /> g , .� Y , a s �
<br />
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