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STATE OF NEBRASKA ) <br />3s. <br />COUNTY OF HALL I <br />James Livingston , after being first duly sworn on oath deposes <br />and says that he is a resident of Grand Island, Hall County, Nebraska and that <br />he is a licensed embalmer and funeral director in and by the State of Nebraska; <br />That, Alexander L. Kalkowski , a resident of Grand Island. Nebraska <br />did die at Grand Island, Nebraska on Feb. 9, 1963 , and that he did <br />prepare the body of Alexander L. Kalkowski , for burial on that date; <br />That, he did supervise the burial of the body of Alexander L. Kalkcwski <br />in Calvary Cemetery cemetery, located in Hall County, Nebraska <br />on February 13, 1963 <br />That, he did see the dead body of U axani, -r L. Kalkowa and <br />did positively identify same; <br />Further affiant sayeth not. <br />Signed at Grand Island, Nebraska this 5 day of kkk March , 19 63 <br />Affi-ant <br />Subscribed and sworn to before me, a notary public, this 5 day of March <br />1943— l <br />,t ,i ;14{.4651 of fry /(/'.�C.�W �! / ►J 1��5/li <br />Notary Public <br />�� �ufi�ris�n ex <br />P ires <br />dCPOPI: <br />YR�,j=¢Y, Filed for record_ April .961 at 8-:30 AM, in Book 11 of Miscellaneous ; <br />Page �� Deeds, Hall County, Nebraska <br />dose Ane 1acogs <br />