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��� <br /> I�YJL� �� ���� l.V �� �1.J � Jl�l�� ��� �J <br /> 21917—Th�Aug�uatine Co., County 8upplies, Grand Island, Nebr. <br /> �+ <br /> AFFIDAVIT ETC. <br /> STATE OF KANSA� �as. <br /> MITGHELL COUNTY ) Elizabeth Mae Troutman of lawful age, upon oath states; <br /> That I am a resident of Beloit Kansas. � <br /> That approxlmately 25 years ago, I first met Jennie M. Seager� She �was married to <br /> Dr. A. �. Seager. After the death of Dr, Sea.ger, Mra. Seager 11ved with thi� affiant for <br /> the last 8 yeara of ,her life. This at'fiant caxrled on the businees mattera oP Mrs. Sea�er. <br /> She alwaya ha.d me sign her name as �Jennie M. Potter Rundlett 3eager�. <br /> During the time that I knew her, she told me of her marriage to Edward E. Rundlett <br /> and I personally sat� a letter he had written to her whieh was addreased to her as his <br /> �dear wifep and was signed, Edward E. Rundlett. They lived in Ellis County Kansas. <br /> Prior �o her marria.ge to Edward E. Rundlett, she was married to Dr. W. R. Potter of <br /> West Virginia. They had a child born who wae named J. W. Potter. This ehild wa� married <br /> and ha.d two ehildren who are still alive. <br /> Mr�. Seagers maiden name wae Jennie M. �ierndon. <br /> I therefor� know that Jennie Seager was one and the same peraon ae Jennie Rur�dlett, <br /> the widow of Edward E. Rundlett; and that they lived in Ellis Coun�y Kansas durin�; portions ° <br /> of their married life. <br /> Further af'fiant saith not. <br /> Signed and dated this 6th day of November, 19�r6 <br /> Elizabe�h Mae Troutman <br /> Subscribed and sworn to beFore me this 6th day of Nonember, 3.9�6. <br /> Orin Q. Jordan <br /> (SEAL) otary Public <br /> Com.expires Dea, 17, 1949. <br /> STANDARD <br /> CERTIFICATE OF DEATH. <br /> STATE OF KANSAS 2b2 25 <br /> State Board of Health-Division of Vital Statistias. <br /> 1.PLACE OF' �EATH; Coun�y Nlitchell <br /> Townehip -------- Reg�.stered No.-----_______ <br /> � <br /> or <br /> City Beloit No. ----------�t.-�---- Ward <br /> 2. FULL NAME Jennie M. �ea�er <br /> (a� Residence No. 313 N. Campbell 5t. 2nd Ward. <br /> (Usual place of abode) <br /> Length oP residnce in city or town ti,rhere death oceurred yr. mos. ds. How long in U.3. <br /> �1' t�f, f�rei�� b:�rth? qrs. mos. d$. <br /> PERSONAL AND STATISTICAL PARTICULARS <br /> 3. �EX Female <br /> 4. GOLOR OA RACE -White <br /> 5. single,Ma.rried,�i�idowed,or D3vorced (write the word� Widowed. <br /> 5a. If married, widowed,or divoraed HUSBAi�TTD of (or) WIFE of A. Z. �eager <br /> 6. DATE OF BIRTIi (month,day, and year OQ�ober 28, 1864. <br /> 7. AGE. Years 6�: Months 8 Da�a � IP Leas than 1 day --hra. or �-- min. <br /> 8. OCCUPATION OF DECEASED <br /> (a) TLa,de� pY'n��881i�33tyQ� paz`tiCUlaY' kind of work At ho�e. <br /> (b) General nature of in�ury, bus3nese or establiehment in which employ�.d (or employer) <br /> (c) Aiame of employer <br /> 9. BIRTHPLACE (city or town) <br /> (�tate or coun�ry) West Virginia � <br /> PARENTS . <br /> 10. NAME OF FATHER John Herndon <br /> 11. BIRTHPLACE OF FATHER <br /> (City or town) <br /> (State or eountry) Virginia. <br /> l2. MAIDEN NAME OF MOTHER Mor�an <br /> 13. BIRTHPLACE OF MOTHER <br /> (City or town) <br /> (State or country) Virginla <br /> l�. Informant Mrs. Mae Troutman <br /> (Address) Beloit, Kas. � <br /> 15, Filed July 3, 1926 Lela B. Harford <br /> _ Registrar. <br /> MEDICAL CERTIFI4ATE OF DEATH. <br /> l6. �ATE OF DEATH (month,day and yearj July 2, 1926. <br /> 17 . I HEREBY CERTIFY,That I attended deeeased from M�,y 1, 1923 to July 2, 1926, that I <br /> last saw her alive on Ju1y 2, 1926, �nd that death occurred, on the date etated above, <br /> at 10 A.M. <br /> The CAUSE OF DEATH was as fol.lows <br /> Ar�erio Sclerosis <br /> Chroni� Interstitial Rie��hritis and <br /> Mltrel Regurgitation <br /> CONTRIBUTORY <br /> (secondary) 12g ( duration) yrs. mos, da. <br />