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�,��,,14'0 �?b <br /> v-0-44-(-6-3° z' a,r�,v- <br /> .ff , a6- � �a . • <br /> A F F I D A V I T• <br /> • <br /> State of Nebraska) <br /> ( s.s. <br /> County of Hall ) <br /> Peter J. Merten, being first duly sworn, on oath <br /> deposes 1-id says that he is a duly licensed embalmer in and by <br /> the State of Nebraska; <br /> That, on August 4, 1954, Lorenzo G. Mentzer, a resi- <br /> dent of 1212 West Charles Street, Grand Island, Nebraska, did die <br /> in the city of Grand Island, county of Hall, state of Nebraska; <br /> That, on the said date of August 4, 1954, he did pre- <br /> pare for burial the body of Lorenzo G. Mentzer; <br /> That, on August 7, 1954, the body of Lorenzo G. <br /> Mentzer was buried in Ft. wcPherson iational Cemetery, located <br /> near to Maxwell, Nebraska; <br /> That, he did see the body of Lorenzo G. Mentzer after <br /> death and did positively identify same. <br /> Further, affiant sayeth not. <br /> Signed at Grand Island, Nebraska <br /> day of f '` _ , 194 <br /> S0.LPVfy„�fih � ✓ ' <br /> • < r affiant <br /> ,,,,,.1<<,;1sCd and sworn to before me, a notary public, on this <br /> X 1St <br /> � day of .. " , 1•. • <br /> o";;;••• /_ <br /> notary pu .` <br /> f <br /> State of Nebraska <br /> Ceunty of Hail <br /> • <br /> ss <br /> Entered on Numerical Index and filed <br /> for record in Office of Register of <br /> De,.�.`-`'s on the day of <br /> 19375 at !l <br /> o'clock and •30 __minutes <br /> and recorded in cook 3 of <br /> ..921/42,c2.22,___... at page <br /> Register of Deeds <br /> By ---- -------------- <br /> 7a— Deputy <br /> Fees $1--t <br /> • <br /> • <br />
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