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STATE OF NEBRASKA ) <br />COUNTY OF HALL Sail <br />J8man LIXIng,ston , 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, Amelia Stoltenberg , a resident of Grand Island, Nebraska <br />did die at Grand Islands Nebraska on February 18. 1951 } and that he did <br />prepare the body of Amelia Stoltenberg , for burial on that dates <br />That, he did supervise the burial of the body of Amelia Stoltenberg <br />in Grand Island cemetery, located in Grand rsland, Nebraska <br />on February 21. 1951 <br />That, he did see the dead body of Amelia Stoltenberg and <br />did positively identify same; <br />Further affiant sayeth not. <br />Signed at Grand Island, Nebraska this 27th day of May, , 19—A <br />% .i�tis A—rZ <br />V. <br />AfA <br />Subscribed and sworn to before_ me,_ a- notary- publio -v this -- 27tH - day of-- y-V -- - - -- - -- <br />19.x. <br />d_d�� �';LOOZ�" <br />Notary Fublio <br />My ggmmjjqikon expires Oct. 5, 1966 <br />% K <br />x �. + �"' 11 Miscellaneous <br />o,�' � ���F�ied for record Maur 27th, 1963 at 3 :55 P M, �e Book of , <br />`�� /,r�.� '•�} Pages"" gister of Deeds, Hall County, Nebrasha <br />�i ` +A Pose Ank taco <br />