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� STATE OF NEBRASKA
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTMEN��H A �T �,�
<br />� HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE Clf�' 1��Fi ��C�t2p OI�V3 ��
<br />FILE WITH THE IVEBRASKA DEPARTMENT OF HEALTH AND HUMAN SL�RVICL�S,;�fA '{tEC,QRD$ t ;�, ,
<br />OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS. ;�. �' °" �' �''
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