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4/12/2012 11:19:35 AM
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002-251
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Rerar: ling. The Borth Half of the Sou.thea.st Quarter, (N SF ) <br />of Section Tine, (9), TownshAr, Nine (9) North, Range <br />Twelve, (12) , West of the Sixth (6) P.M. <br />AFFIDAVIT OF BURIAL <br />STATE OF NrBEAtSKA ) <br />CLUNTY OF HALL ) <br />I do hereby swear that the Miller Godberson Funeral Home, of :Shelton, <br />Nebraska, made and completed the burial arrangements for the late HomepSnith, <br />formerly a resident of Hall bounty, Nebraska, and that 1 personally officiated <br />at the burial services for the said late Homer = imith. I do also swear that <br />I know, of my own personaly knowledge, that said Homer dnith' at the time of his <br />death, was the husband of Mary Brebner Lhiith, and i further swear that the <br />body of the said late Halter '_inith was laid to rest at <br />ors the day of <br />Dated this I day of February, 1955, <br />/i!/ <br />tos,�, &,and sworn to before me this day of 1955. <br />— — <br />J NOTARY PUBLIC <br />F'1? ee ,CST r_ r d °u,ir:y' <br />
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