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�'�� I�IISCELLAN�OUS R�CORD V 2908H-�TNt�U6YfTINHCO.iRANDIfL�ND.Nl811. . �� AFFI DAVIT - STATE OF T�IFBRASKA, ) ) ss. AFFIDAVIT COUNTY QF HALL. ) J. Samuel F3utler, being firs� duly sworn, says : T am bersonally acquain�ed trith Rudolph Brunholtz,, �r�,ntee in deed recorded in Book �9 on Pa�e 26 of deed records of Ha11 County, Nebraska. Said Rudolph Brunholtz is in possession of the south one--h�lf of Lot Five (�) and all of Lot Six (6) in I�lock Five ( 5) in the Fourth Addition to Cairo in the county of Hall and state of Nebraska. T titi*a5 personally acquain�ed t�3.th '^Tilliam B. ?�laite, one of tne grantees 3.n d�ed recorded in Book 6� on page �I-,6 of deed recoras of Hall County, Nebraska. Said tiJ3.11iam B. I^laite was the same and identical persvn as William B. Udaite, who died on r��Tarch 2r, 1939, and was the husband of Cora A. ?�aite, the other grantee in such deed and the father of Opal M. Piersol, grantor in such deed. J. Samuel Butler Subscribec� in my presence and sU�orn to before me on tnis 3rd day of October, 19�-9. titi'. E. Sorensen (SEAL) Notary ublic. COi��?I•ZISSI�N EXPIRES JULY 20, Z955 Filed for recorc� this �- day of October 19�+9, at 9:C�0 o ' clock A.M. �� Cc�� Register of Deeds 0-0-0-0-�-p_�_p-0-0-0-0-0-�-0-C-0-0-0-�-0-0-0-0-0-0-0-0-0-0-0-�-0-0-0-0-0-�-0-0-0-0-Q-0�0-0 ^/ CERTIrICAlE OF DEATH STATE OF NEBRASKA Do not write in tnis space Form 243 Department of Health--Division of Vital Statistics F 293z CERTIFICATE OF DEATH l. PLACE OF DEATH County ?iall ToT�rnship ( If dea�th occurred in a hospital City Grand Island No 2�+7 Street South Plum Street (or institution give its NAME (instead of street and number. Length of resi�ence in ci�y or tc�m �There death oecurred 1� yr- mo- c�a. How long in U. S. if of fo�eign birth:;�yr. mo. da. 2. FULL T1AME Mrs Jennie G. England —' `" Resic�ence 2�-7 Sou�h Plum Street PERSONAL AND STATISTICAL PARTICULAF.S �. SEX Female . COLOR or RACE �rrh.ite 5. SINGLE Married Z�Ji dowed Divorced Married 5a. 7:f ma.rried, t�►idowed or divorced HUSBAND of or WIFE of P�ir. Lorenzo J England 6. DATE OF BIRTH (mo. } April (day) 3 (yea.r) 1�73 7. Age Ye�Lrs 61 Months 11 Days 17 If less than 1 day Hrs. or Min. �. Trade, nrofession or p�,rticul�,r kind of work _r`,one, as sbinner, sawyer, bookkeeper, , etc. Housewife 9. 2ndustry or business in which work Uras done as silk mill, saw mill, bank, etc.----- 10. Da.te ceceased last workecl at this occupation (month and year)--�--- 11. Total time (years) spent in 'this occupation--___ 12. Birth�la.ce (City or Town an c1 (State or Country Illinois l�. Name of FathPr I�Rr. --- Feern 1 . Birtht�la.ce (City ar Town of ( and Father (State or Country I1linois 15. Maiden name of P�?otner Unknown 16. Birthplace (City of Town of ( and Mother (State of Country Unknown 17. INFORMANT Mr. L. J. England (Address)2�-7 S. Plum 5treet l�. �t3R��,;-5��4fl��9�1, or REA�ZOVAL Place Gentral City Date ��Zarc:n 22, Zg35 ` 19. UNDE�TA?�ER Evans- Green (Ac1<�sess ) 410 Zdest Koeni� Street 20. Filed. Mar 21, 1935 Pdargaret Paulsen Registr�r. MEDI CAL CE?�TI FI CATE �F DEATH 21. DATE OM DEATH r�arcr_ 20, Z935 22. I HEREBY CERTIFY, ^hat I atten�e� c?eceased from 3-1,5, �935 to March 20, 1935 I last saw her alive on 3-19..1935, death is said to have occurred on tn.e date stated above, at 12.45 am. The principal cause of death �nd related causes of importance in order of' onset �sere as follows : D�.te of Onset P1.eurisy �_ZS_35 Broncho-Pneumonia 3_�a_35 Fa3,lin� heart 3-19-35 Contributory causes o�' im�ortance not rel'ated to �rincipal cause: Name of operation None Date of------ What test confirmed dia�nosis Chemical Was there �n autopsy.' No