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<br /> �1I� �C]E�,�LA►�T]E�LJ� �3�EC ��� �J i
<br /> 21917—The Augustine Co., County BupPlies, Grand Island, Nebr.
<br /> 10. Date rteceased_ last wor'� at t'�� =� ^�cupation (r�onth and yea.r) Nov. 19�+3 .
<br /> 11. Total time �y-�.rs) s?�ent in thi�; occupation �5
<br /> 12. BirthplacQ. City or Tot�rn--Westphalia.
<br /> an d.
<br /> St�te or Co•�ntry --Germany
<br /> 13, Name of F�ther Ernest K1ein
<br /> 1�-. Birthpl�ce of F�,ther City or lown �destphalia
<br /> �nd
<br /> S���e or Country GPrmany
<br /> 1J. Maiden n�me of Mother Friedricha Stallmann
<br /> 16. Birth�l�ce of Mother City or. To��+Tn westphalia
<br /> �nc�
<br /> Sta.te or. Country GPrmany
<br /> I Ii�r ORi�iAi�tT Erna s t Hor. s t
<br /> 1 .
<br /> 7
<br /> (Address� Doniphan, Nebras'�a..
<br /> l�, BURIAL, CP.rl��1.?��IO�v, or Rr2�i0VAL
<br /> Pl�ce Doni��han, Nebr. �ate 4I2z�19�+4
<br /> �9, U�dLE'�iAKER Livin�ston-Sonde'^mann
<br /> (Address) Gr�nd Island, Nebraska. ,.
<br /> 2p, Filec� Anr 20, 1944. F, t�hite, �e�istrar.
<br /> MEDICAL CFRTIFICA^iE OF DEATH.
<br /> 21. DATE OF DEAiH April l�, 19��r
<br /> T-� -�t � _ I (, t.
<br /> 22. I H�R.�3Y Cr��TIFY, Tnat I attented decea�ed from Jan. 31 19��- to �-18 194�. la..�t a� a
<br /> ner alive ^r� 4-1.594�+ c�eath is sa.id to na.v? occurred on the d.�.te 5ta.ted. �bcve at
<br /> 1: 30 A. M, lhe nrincip�l cause of d.e�� 1 ��r,a relatec� ca�.�se of importance in order of
<br /> onset �,�rere as follows:
<br /> D�,te of Onset
<br /> Carcinoma o�' colon descendin� '� ImT�ortant
<br /> Metpstose� �� liver a.nd. ��eritor�PUm Fall 1943
<br /> �or��ri'putory c�usPS of ir��ortance not relatPd to t�rinci���l cause:
<br /> N�.me of oper�tion - --(�
<br /> Wn�t test con.firmed di��gnosis X-�y '�as tnerP ��n autopsy Ido.
<br /> 23. I#' d�a.th t�.�as due to extern�l causP (violer�ce) fill in also th? f. olloTaing:
<br /> Acc�c�.ent, s�aicide or homici�.e ----Da.te of---- 19----
<br /> 'anere d.id �n,j�.z�!'y occur. -----� �pecify city or toT�rn, coun�y anci atate)
<br /> Sr�ecify w:�ether �n.jury occurred in Inc;ustry, ir. homP or in x�ublic ��l�ce.
<br /> Manr er o�' in,j��ry
<br /> Nature of ln j�zry
<br /> 24. '�las �iseaGe cr in jury in any nTay rpl��tin� to occupation of �.ecPased No.
<br /> If so, s;>ecify
<br /> ( Signed) j�. C.Woodruff Z�I• D•
<br /> (Add.re s s) Gr�.nd 1 sland.
<br /> 25. I hereby cArtif.y I ��ersonally em��almed �h� body of the deceased named hPreqn.
<br /> J�mPS D. Livingston License No. 1�3
<br /> 'I':�I� CEt�'�'iFI�S ir�,� A:?O�IE rI0 :�E A 'iR'.?E COPY Or ArJ 0�IGi��AL CE�=��i�IFICATE Oi�i FILE :�lI�li� i�i-iE DIV-
<br /> ISIOiv CF �TITAL S'iATISTICS STA`I'E DEP.ARTP�I�IdT OF HEALTH, ��T:�iCH IS Tr�E L�GAL DEPOSITORY FOR
<br /> SAI�IF.
<br /> C.A. Selby M, �,
<br /> sT:'��rE REG�,sTRAB
<br /> LINCOLN, �1EB�ASKA May 1 194��.
<br />� ;�. � � v
<br /> ,
<br /> Fi.1P� for r�cord th:�s 10 c�ay of May, 19�- , at �.00 o clock P. II. ,
<br /> Register of eeds
<br /> 0-�%-:'-�-�'-0-�-0-0-0-�-'�-0-'%-�-�-'�-�%-�?-0-0-�-�-0-0-0-Q-0-�-0-0-0-0-0-�-0-0-0-��-'?-^-0-0-0-0-
<br /> AFFIDAVI�
<br /> STATE ��' NEBRASKA )
<br /> )s8. AFFIDAVIT
<br /> COt1N�'Y OF HALL )
<br /> T� �PHOM IT B�Y GONCERP�: Rey Lo� 9,Hlock 1�, 3.n Wallich' s Addi�ion
<br /> to arand Is1�nd,N�braBks.
<br /> I,C.E.Grund� oP Grand Island,Ha11 �nunt�,�Tebraska,being �irst duly sworrj,,upon oath depose
<br /> and sta.�� that I h�ve been a resident o� Grand Island, sinc� 1915,a�d �iat I am perspnally
<br /> acquain�ed with I.K,�icF�riand to rvhom 1)�vid KauPmannconneyed the ab4ve-described trac� by
<br /> �Varranty Deed on Apri1 1�,1917,and also with Irvin K.�el�arland,who w3th h1a wiPe,Yate �.
<br /> McFarland,cor�veyed said tract to Rcabsr� D.Blankinship under date os ��y 26,19z9;
<br /> And a�flant poai�ively kno�s '�hat the sa3d I.K.I�cF'�r1�nd,Grar�tee,and Ir�in �.�aF'�lar�d,
<br /> Grantc�r,are ons �r�d the sar�e person,no't�i�b�s'�s�ndir►� the seemirr�g d�.serep�ncy in names.
<br /> Furth�r Aff 1an�G saith not. C.E.Grund,
<br /> 5t�tascrib�d afld sworn �o bePore me this 10th d�y o� �ay,194�,at Grand Is1�nd,Ha1.1 Count�*,
<br /> l�ebraska.
<br /> (SE�iL) Florer�ee V.A�,�rs
<br /> l�y aommisslon expires Au�ust 27,1949. , --- Nvtary Pub].i�
<br /> Filed Por reco�d this 11 d.ay of May,19��,at 2 o'cloak P.M. ���:��� �
<br /> ' Re�ister o� D�eds �
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