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<br /> �� �� �LJl.e� l�l �� �.J � ��� �1L�� �.J
<br /> 21817—The Augustlne Co., County Bupplies, Grand Island, Nebr.
<br /> (a) acciden'�, suicic�.e, or homicic�.e (specify)
<br /> (b) L��te of occurence
<br /> (c) `;ri�el�e i�ic� in�ury occur
<br /> (d) Did in,jury occur in or �til�ou� ��ome, on ��rm, in in._ustri�.1 place, in public place.
<br /> 7T'nile at T,°•ork ( e) ::ie�ns of in�ury/
<br /> 23. Si�n<:;ture A.P. S;�n�iorst 1�7.D.
<br /> Ac�c�sess� Grand TI land, Date si`ned 10-7-'�3
<br /> T�e�r.
<br /> I hFreby certify I person�;,11y em�alMed t'rie ��o�"y of tne deceased named hereori.
<br /> Lee E.Nicholas License No. 1211
<br /> T?r:'S CEr�TIFIES THE A�30VE TO BE A TRUE COPY OF AN ORIGITJAL CERTIFI CATE ON FILE ',°1IiH THE
<br /> �TATE D�'PART�Z�NM �F HEALTH, B��'REAU 0�' VITAL SmATISTICS, 'r�FiICH IS THE LEGAL DEPOSITORY FOR
<br /> VT�:AL RECORDS.
<br /> ' ri.S.Petty M. D.
<br /> I EC OR OF T � STRAR
<br /> ' LINCOLTS, NEBRASKA Jtn 30 �9�+6
<br /> Filec, for record th�s 2 da� of Au;us't, 19�6, �,t 1:30 o� clock P.M. ���� �
<br /> eg ster o eeds
<br />� 0-0-0-0-0-0-0-0-G-^-0-^-�-�'��-�^�_O-C-^�-0-�)-i�-:�-�-^-�-0-^-�;�-'�-�-0-0-0-C-C-0-0-G`-C'-�-!�-0-0-0-0-0
<br /> AF�'I DAVI T
<br /> IN RE: Title to the �outn��est Qua.rter (S��514) of Section One (1)
<br /> in Township Eleven (11) . IJorth, R�nge Ten (10) , ��5les t of
<br /> the Sixth P.p?I. ir� Ha�.l County, Tdebraska.
<br /> AF �' I DAVI T
<br /> STAT� OF IvEBRASKA)
<br /> ) ss ROBERT NEU2�IAYER, being first �.uly sti�rorn on oa.th �
<br /> HALL COUNTY. � deposes an says that n.e was well a.nd personally a,c-
<br /> quainted ti,rith Katherine Neumayer c:uring her life
<br /> time. Tha.t he is the BROTHER of the said Katherine Neumayer. He knows o�' his own per-
<br /> son�l knoti��ledge that the saic? Katherine Neuniayer c:epar�ed this lii'e on the 30th day of
<br /> October, 1937 in the city oi Aurora, St�.�e of I1.lir�ois ��.nc:� ti,ras i�uriea in the ceMetery at
<br /> P�Ienclota, Illinois. � '
<br /> Furxher de�onent sayeth not. �
<br /> Robert Neumayer
<br /> Subscribed ^.nd stti*orn to before r�e this 16 day of P��,rch, 19�+5.
<br /> (SEAL) E. R. Quendel
<br /> ZZy commission expires �-29_�-�. Notary Public.
<br /> Filed f'or record on this 5 day of August, Zg�+6, at 2:30 0 � clock P.1�2, k'
<br /> ��d �
<br /> �egister of �eecls
<br /> -0-0-0-0-Q-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0_0-0-
<br /> AFFID�IVI`T'
<br /> ST.�TE OF NEBI�ASKA )
<br /> ) s s Hax'1 ey G. Candi sll, b e ing f 1r s't duly s�rorn on hi s oath dep o s e s
<br /> HALL COUNTY " ) an�l sa�rs tl��.t I am acquainted ��ith Roy r,li. John.son and Clara S.
<br /> Jo�nson, t�rho deed Fractional Lot One (1) , Block FiPty (50� ,
<br /> Pacl�er & Barr 's SPCOnd Addition to tlle City o� Grand Island and its corQplement Frac. Lot
<br /> Eit�ht ( �) �.Tl B�.00�:L Four (�+) , Kernolian and Dec?�er� s Addition to the City o� Grand Island,
<br /> Hall County, Nebras��a, to Donald Johnson, a son oP Roy l�. Jol�nson, and tilat the said
<br /> DonaldJohnson, is also kno�rn as Donald L. Jo�inson; t�Zat tlle said Donald L. Johnson is
<br /> the same pQrson that deeded the above described premises to Simon J. 5hada & Estelle M.
<br /> Shada, by� warranty deed recorded in Bool� 90, pa�e 3�7, in t}ze ofYice of �he Re�ister o�'
<br /> Deeds, H�11 County, Nebraska. ,
<br /> Dated this 6tk�. Au�ust, i9�6.
<br /> Ha2�1ey G. Candish
<br /> Subseribed and scvorn to be�ore r�e tizis 6th. c�a,y o� Au�ust, l�i�+6.
<br /> C. E. Grundy
<br /> ( SEAL) Notary public
<br /> R2�T commission expires June l;, 1�50.
<br /> FiZed $or record t�zis 6 day o� AuPUSt 19�46 at 2;15 0'clocl� P.��:. �� �^��� �
<br /> �
<br /> e� s er of Deeds
<br /> -t�-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0-0_0--0-0-0-0-0-0-0-0-0-0-0-0-0-0
<br /> '�
<br /> ___ .._ ��.�� I
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