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1 " - , i°a� <br />AFFIDAVIT <br />State of Nebraska ) <br />( BOB* <br />County of Hall ) <br />James Livingston, after being first duly sworn,,,on oath <br />deposes and says that he is a resident of Grand Island, Hall <br />county and is a licensed funeral director and embalmer ih and <br />by the State of Nebraska; <br />That, on December 17, 1949, he did prepare for burial <br />the body of Lois Ada Miller, a resident of Grand Island, Uall <br />county, Nebraska, who died in Grand Island, Hall county, Nebraska <br />on December 17, 1949; <br />That, on December 20, 1949. he did supervise the burial <br />of the body of Lois Ada Miller in Grand Island cemetery, located <br />in Grand Island, Hall county, Nebraska; <br />That, he did see the body of Lois Ada Miller after death <br />and did positively identify same. <br />Further, affiant sayeth not. <br />Signed at Grand Island, Nebraska this _ 7 day of <br />195. -• , <br />affi u- <br />Subscribed and sworn to before me, a notary public, on this <br />o e 7 day of 1954• <br />notary public <br />z . � I P-17- p a- <br />iot' on expires „�,� L� O <br />11TYs <br />State of Nebraska <br />County of kia °l <br />ss <br />ntzrcd on Numerical In.dem and filed <br />for record in t: dice of Register of <br />L -eerls on the .-..,--.2-Q ------- day of <br />Septem} er_ -. 19-58 -- at _1Q - - - -- <br />o'clock wml ___55 -- Minutes <br />and recorded in Book __6 ---- . - --- of <br />Bisael, at Page------- - - - - -- <br />----- - - - - -- *B na- Bobn---- - - - - -- <br />Register of Deeds <br />By Q epu -- - <br />Fees $ 1A-5�1 - - -- <br />
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