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4/12/2012 9:10:29 AM
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006-369
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Ftate of yebraFka ) <br />S S: <br />County of --Tall <br />Tld.-abeth TTIcnoth, being first duly <br />s `,-Ts t h at Fh e is t h c d au g h t cr of <br />-er�-OnC <br />e I- -now - 0 In er E: <br />AP, F I D AV IT <br />sworn., on her oa-th eaI6 <br />7Uel--ol-l- al-irl that <br />that pd dlic- <br />( i ed on Jul '7 213 i J 12 0 il T-0�1 C -Lj,,�ty ' <br />'o c!,urvivcd by <br />bc,r,(7,, Pu&I-ov-, the father of affix -lit; thiE affidavit i�' C,,ivcm in <br />r-e--arr' to tl,c <br />TtL <br />ne" t (a — dl ror <br />,`CJ ill GO -Y <br />n <br />y 1 1)S 0 <br />WRES 0- <br />T C-j <br />4 <br />Etaf-e of Nelmas6 <br />C-U.11ty of <br />On Iaiumer:lcal Inclax and f,.!ed <br />'-'ecol'd Ln E. Ld'4ee of Of <br />Oic day of <br />Febrqary__,_ t <br />O"AG - <br />—3D <br />6 ------- Of <br />of LIceds <br />By------------ --- <br />Fees Deputy <br />cr of cct oil <br />7 an <br />71'c"t of <br />t' _E 'th <br />col nty, --ellra-I C'- <br />7 -ot <br />0 in <br />71och <br />1�' L- r <br />t -11 to t,�, c 1 vj <br />��f <br />Tc�lanrl <br />TtL <br />ne" t (a — dl ror <br />,`CJ ill GO -Y <br />n <br />y 1 1)S 0 <br />WRES 0- <br />T C-j <br />4 <br />Etaf-e of Nelmas6 <br />C-U.11ty of <br />On Iaiumer:lcal Inclax and f,.!ed <br />'-'ecol'd Ln E. Ld'4ee of Of <br />Oic day of <br />Febrqary__,_ t <br />O"AG - <br />—3D <br />6 ------- Of <br />of LIceds <br />By------------ --- <br />Fees Deputy <br />
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