Laserfiche WebLink
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
STATE OF NEBRASKA ,4` : ; , <br />- -... <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTMENT OF HEALTF� i4ND f'iU1M�V S�RVICES, IT CERTIFIES <br />THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD ON FIlE WITH THE NE'B. �,Q�f�i7��' AND <br />HUMAN SERVICES, VITAL RECORDS OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR �I'�.. RECOR ��' � �' <br />� . � . � �, �.. }�', ��j� � v � ._ , <br />5./ � `�.: <br />DATE OF ISSUANCE <br />. Aa7 {• � .. b�1r�� '� <br />, 5�'�9NLE S, OOP'Elt � � <br />OS/16/2012 `��S�y�I7'�9�Ef �G����4I� ; <br />o,.�P. b��r�`d�rH �tvt�, � : <br />LINCOLN, NEBRASKA � SEf��IG�6;� ,�� � <br />� <br />201204719 A� ��;•�����,�:{�.��� <br />. <br />���,'>r �;�� - <br />�• � �t���� � ,,� <br />,� <br />� . � , �, :; .���R <br />' ; ' _ , .,, <br />.. <br />_ _ . � ,e�r .. <br />$TATE QF NE9RASKA - pEPAFtTMENT OFHFAI,TH ANO HUMpN &EFtV10E$; 1� � J l V J <br />' ceanFlCnrE c� oee„Tw' . . <br />- .1..� 1Flb4� '��� WddI1:� �.. . .. � . �.. �� W6� �.�� . .. ��` � SW�) 2:BEX ..: ��� � 3�DATEOf:OEATH (IIn.�.DefSYc) - . <br />Rictaa.rd Ral Male , 6 2f112 <br />j:� bCRPAlm8vCt8Gq7EHhITOFLY.Ofl�FOAEEKiN00UN'[AyOFBIHIH� ... 6n.ilti[�WtBwWey �� 69rUN��IPAY. �, ���- &pAE0FMNIH� (A1a;a0:Yr.) � <br />�Ytc�:.; �:�� M09. �. OAVB FplplBr MINB.' -� �� . . <br />Atsh�an. Nebraskg. 84 Qctaber 24 1927 <br />7 BOCUlL N1}e�Epl Bai PIAGEOF OERFi <br />508-32-78'1'l < �.: ; o�rm � gj w�y �.n:rc O rrowb• r�nri <br />enF�urt�t�w� At,��an�ee�anapm4er� O mrouqu�rd O oememu'n►acie <br />:'1"j.f�Bl�y &]F]aLtB Ll DOA D DuwlePemh) <br />'�- :Be.CITYOflTOWNOFDERH��O��nP�vde) . . . � .._ -.. : � ..� � : BddOUNTY�OFDE71iF1� �� . . . - . . . <br />' Grand Is].and ; 688p3 <br />eq.x��sr� �,:c�wrnv� �o:Cmrowta+vr� _ . , <br />l�raska ;I�al:l Gr�nd ' Issland ' <br />sxsr�iwu� > ' _ so:npzr�o eenaaao� _ eg.p�cmr�uars <br />3119 W. Faid}.ey AVe'. I ': ' 68803 ; 7D rES O no <br />. : .. �IDaYAAfGL8TA7U8ATTINEbRDEATI - � NaeYG ON�wNmMd� ` tOb.NA4E0F8P0U8E.�.(Rn4W0A� ��: ; ��. - .�..� <br />q►tw�ra.,,me�mma owuw�a aoi�ea �,m�n Ar11e C1e��eve Fbei], <br />�.-it.FATXER'SNA11E (Flrq, _�- �� bli�e. La�<. BuRU) i2iIdOT11EF'&NAME� (Gin4 ��WddM� MttlN�BW�me).���� � .. <br />� t7 <br />�13.8V�SINL:B.��ANYmFORf�97AMN�ao1Nroltl�Uya� 14a.I,NFQflIIRNTNAME. :�:�.t�E,HEUIICON8MPT00EpEDENT , <br />ir�, na a u�r:1 ND; Ar.'Liel.. L`.. JSSiIOCtl iilT9.fe <br />16.M6T}IC�OFOISP0.SRION�. tl8l�:�N�S1 1Eb.LGENSeN6. � �� 180."OAE (A1a.GeY.Yr.j . <br />�� o � odrA- � 1:078 '.10 1 <br />S3cr�n o�owrom�� ,ea�rEm;ct�CrwrtoAOr�+�orr�nar , , `. an,�iu = su�: ' ' , <br />�n�: Ooa�t�ml � C�met� �p �i,tY� Nebraslc,a <br />,�a.��wv.rw�Ewua�;amu,uu��voo�s� ts�..ecerwu.ns�reY ,r�.ancaae <br />;Peters; Ftu�alr�1 Home,y 71tC. F.O.. Hoot.181 St. I'auil NE 6fl873 _ <br />.�.�.....�,..w.�.,��,,a.��.n��.���. m.,....,..._..,_..� <br />_. � <br />: +m�a�ya�r.orvon�itownrro�ueuare�aaelq.anpmsaemoWrqo:e�orASm�vure.rum�r8nyorecmnemem�.Aadaa�ra[une�:n��ac�ry..: i <br />�;.'. _:.�:� �. �.:._AeNED4�TeC.l1U8E: �� . . .._ - .�... ... _ � :. ..,,. . . .,. ..�Do�qtodWh <br />I <br />'' ' c . T � @ .�.-�t l, � 1-s, , �,.�r �.�., c <br />�.�dq�MOr�aqNYllanrwW9oY-..��: DUHTO�IXiA9AC0�EWENCEOF: ���. :. � :: . �� �m�dmd� . . <br />Maan� - / � � r-�f"� <br />m� s�.�l : « w.l:, � h�.M�� � i <br />. p �� � : �- DU6'[G OR A9 A EWlENC.E OF: � �. . � � � �� .. .. � a�aA m det9� . : �,: � <br />YmdmYnac , , , _ _. , . � <br />, i <br />` . i <br />�.�'�EnIRDNtAi089Ltp�W �, (a) �;.,.. : . . �� , . . .�.� .. <br />c�9e(a�ra.a�n�r uue10 .0AASAC0EI8EWEWCEOF : : iaunroqeuh:. <br />Meaaar,�e.�..e�ny ; � <br />b+Mmj�ear _ � ., <br />(� _ . <br /><. ' ;: ; - <br />: <br />, i ;: <br />ia.a�m�i�.orneRSwru�cuar�ormrtro�aonn�mn�mnrawmewom�moymdro�++o�uqoeoa�anwr�wt'�. wo.rrnsti�wcusiueueEn <br />'�+►,�� � �Q`_'(� oacoaoNm�wn�r�v <br />?: C E3•� �, a r�s o�ao <br />1CIFFEWIk : @fa AFp@ATH.,..:. '�� tb.lFTflANSPGRI7RI�-1WN% Rt0.WA8ANN7TOP8VPEFFORME04 <br />D Na aro� paurw �t a�ddo ° Drberf0�°r o rES r3tPo <br />�� ri <br />O anaumuNmsde�tn `> DilwlimuGllPa�plm�aNytlm ', <br />13 Not�anqogmmw�meam7amiteam 08wma Ocm,temthadmm�t�"- �� S1dY�AEUt[OFAYFUmwodAtwu�E'[o <br />, p wevro�mm:an,re�?uam�ro,,ro:�oeraaaam ': , . ,..;- aopbr�sv�,1 : -'ca►�cw�oFC�a�rr <br />.��] unian�mdpapnontrrttldnewptaydc � �. �:�:GI vEe :�:�ONO . �. . . .. <br />. ... ,. . . . . . � � . � . , . _ . . . . . . <br />.22p.DATeOP:NWU10 (Ye��OsY.Yr.� �'�� �7di.71ME0FIN,0IRY �.PI.ACEOFINdURYdtAo�qB�hn4.atre6R1ida1S���q.aonahrbloiia44�S�Y) , - . � ' . -. <br />;; m - : <, , __. ,. <br />INJUAx:ATlYOHK? �.��2acesCipBE��HOWqiJURYpfxIIHRED .-� ... . .. <br />❑� L1N0 --- -� <br />' Rzr:wcxrtoMoFUwar-arn�te►w�a,�ar..►a.:': _.--rxrr.�N ' - ,, - — y� - �� ~ ; ; ' <br />:�� Z#�.OATEOFOEA7N:� �tlay,Y�) ��� �2/a.DATESIONLD (Ib.,W�;YtJ � 24b.'�6lEOFDEATH �� . <br />� •. ' ' m : <br />:� 7dU. QATE �qF1ED (�, �a9.YrJ - 7JC.T1I�QF D ���� � ZI¢ RHQNWNCED D.EM Ma. Dl1SYt) H4dTUAEPRONOUNCED DFJtD m.. :- � . <br />� � .r r lt ' > <br />29d,TP1.�M nn:W�or�ye. ... u+.�.mre. ana ~�� onmena�e�t�amirorurv�+ron.m.nno�w^awmoca�aa <br />E� aiiqa nnae�a(el ,� � , mewn:dnaaaaWouaausowroraa(.)mdeA:c�nuureudrm.�• <br />H � o _ <br />, ; ; � '_ <br />_ . _ _ _ _ <br />�� 46D1D ....... U9ECOMRIBU�TOTHfiOFATFI7 .IIdi:1iA8�ORGANOHTl9$UEDONA110NBEENCOMSIDEREDt•: .. � . <br />:� u RES �. ��u:�NO �6l��.PR09I1�Y�:.. I+�ICKNWVrI. � �� . � IJ YEB. � . �.l�NO��. � �.. �.� . NotA YoeWa . U YEB: � , 1/'ICQ <br />�.@7.NAM�, AImA0DRE9SOPCEfl[IFIER(BMY8ICUN��PHtt81C1AN .COR4 . <br />� �.4.� '�. �.` � .!�� . �. - . / � � ".�.'�. . � WN - -; � . D� ....�: <br />CBe.RENBTRIW'S8I6NAUPE '� � 280.W175flLEU9YtiEGI9tM8 (61n,.U+P.Yr.) . <br />i <br />, <br />• Y 14 2Al2 <br />;. , - _- , ; ; <br />_ � ;:: <' _ <br />:, <br />HM3�81 f�9W 7/� (650611 <br />I 1: <br />