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�� . . • ..�.�X� <br />:Js� T'..v,.,. . . _ r— � <br />`f' <br />� � <br /> 5.�' <br />� 76- R06_11�� <br /> � r <br /> I� FF I Dt� V IT <br /> PERTAIN�NG TO LOTS 69 and RO in <br /> BET�MONT ADDITION TO THE CITY OF GRAND ISLAN�, N�BRASKA <br /> State of Nebraska � <br /> County of hall � ' <br /> ,�ames Livingston, after oeing first duly s��orn on oath deposes <br /> � antl says th�it kie is a resident of Grand Island, Hall County, .�ebr�ska <br /> 'r <br /> aiiu is a licenseci e:nL�l:uer F.iu S'u:iersl Q17ECt0I' lfi �r.0 Y,y trce State <br /> i <br /> oi yeUruska; <br /> `: <br /> That, on Septec�er 3G. 1957 tiugust Uibbern, u resiuent of Gr•arid <br /> Islund, H�11 County, Nebr�sxa did die at „rana Isl�nd, IQebruska and <br /> that affiant did prepGre the uody of hugust dibbern for burial on that <br /> ;: dete; <br /> �` Th�;t, on October 3, 1957, kie did supervise tl�e burial of t!-ie bony <br /> of !:ugust Uibbern in 4;estl���n P'.emorial Park Cemetc:ry-, loc�teci in Hall <br /> COullty, Neb2'�iSKb, <br /> o-; <br /> . Th�t, k�e dia see the deaci uocy oi' t�ugust �Dibbern and did positively <br /> 5 <br /> identify szme. <br /> r; <br /> + Further �:f'i'iunt sayeth not. <br /> 3 <br /> 3 <br /> } �igned at Grand Isl4nn, Nebr�sks this�� day of October, 1957 <br /> ? j� / �./�'---- -/—� <br /> x. � .�r�'�2r',�.rl _r• ./y.c-/r.-r.�ro/fZTJ�- � <br /> ;�; / af'f'iunt. r— � <br /> �l (/� <br /> Sutscribea �iici sv�orn to before rr:e, a notury public, this,�� aay of <br /> ` <br /> vctober, 1957 <br /> ...,�,".".;,���:;,;;,,: <br /> � r;. (?j ,,:::; � . <br /> ��,'�,y''1 T'�,'�1�:;h'.! <br /> `'� ' ' notary public <br /> ' '•�K "{ <br /> 1. .•^ . _.:: <br /> ( �� ���� '.� <br /> : •�� comm��slon e:cpires �.,"���•� <br /> ., . ��` � . � �N' <br /> C„� �`. � � y' <br /> L , a <br />}� ' ... ' zt <br />�' � <br />�.: cv <br /> � <br /> b�. <br />�� <br />�-� <br /> 4r; <br />- � � <br />'�+� <br /> '�) <br /> l <br />