Laserfiche WebLink
All of Block Eighteen ( 8) and a stripp of ground''ha;vingg a frontage of -Thirt - <br />-three (33) feet on Firs Avenue -off of the West si a of Block Seventeen (175 <br />in Koehler Subdivision n the City of Grand >Island Nebraska, as said addition <br />is surveyed, platted and recorded: <br />DEPARTMENT OF THE ARMY <br />OFFICE OF THE ADJUTANT'GENERAL <br />WASHINGTON 2S,-D.C. `• <br />RE DER <br />STATEMENT OF DEATH <br />ACTIVE <br />3t _ <br />BATTLE <br />° t� �u <br />RETIRED <br />NON-BATTLE <br />NAME <br />So O. <br />a <br />R AN AT D TI it aaelQnsd to medical holdlnQ detachment, afro lbt prior orQanlaatlor� <br />L0 � dat a �roup, 12th InP <br />SERVIC NUMBER <br />, <br />RA,17 071 472 <br />HOME ADDRESS 1" un t auto <br />R�SERVICE <br />ELECTIVE SERVICE NUMBER, LOCAL BOARD NUMBER..CITY AND STATE <br />D T# 1 9~3 5P <br />CJUONENT <br />PL*&W ATM <br />D 6 E <br />R ND E#tGRADE <br />CAUSE OF DEATH AND CIRCUMSTANCES <br />COro=ry thromboolS <br />B <br />INX0ftVV (d PAY <br />D fW5At-956TRY <br />P OR SERVICE <br />0 YES Q NO <br />Rvemaelan <br />RfttWM&tWEFERENCK <br />NOTE: When imprinted with the official <br />seal of The Adjutant General's <br />Office, this form requires no <br />signature. The form may be used <br />to facilitate the cashing ofbondq <br />the payment of commercial insur <br />ance, or in the settlement of any <br />other claim to which proof of death <br />is required. <br />BY ORDER OF THE $E' TSAR OF,THE ARMY: <br />{' <br />HOER Frl1 :�%J�N�E� <br />M4D*r.Genera1, —VSA y f, .. <br />the "(dlrc u't GenexWr .; <br />D/� FORM 5 7 -7— C 6 J 3 b C <br />/'1 1 JAN 67 L L <br />