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.. -_ _ s I � � , , {�1HEN THIS COPY CARRIES THE RAISED SF.AI. OF THE NEBRASKE�!!'�ATE�oo�+5� � � DEPARTMENT OF HEALTH. IT CERTIFIES THE SEI.OW TO BE A TRU� COPY OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPAATHENT OF' t1EP1LTH aUFEr?aU Or^ VITAL STATI,�',TICS� �1;iICFi IS `I'HE LECAL .t3�1'Q�,�'fTfJP�Y,�f�I.r' � VITAL RECORDS. ' ' �'a°;.,�'. � � ' '�"'' . . DATE OF ISSUANCE ,�..�, __ � , ' +�,v, AUG 3 1 1989 STANLEY`Si �OUPER��D"�CTOR " .�Y�• •: L' LINCOLN, NEBRASKA BUREAU 0�,��'��S�,�ICS , , �-.7, J 60�, ..�..'._-,--.-. - � STATE OF NEeMlKA—DEPAR7'l1ENT OF HEwl.TH � eu�u o�wr�srans�rica CERTIFICATE OF DEATH t�_/(o() /.DECEDEItT-MAMI! FMIST WOOLE lA3i 2 SEX J.DATE OF�EI1TM IAAxYM1 OrY.Y�M! Maurice Donavan DeVore Male Au st 14, 1989 . �.pilt I1N0 STATE OP M11fM (Y ml�CIS�t wM oanlY) S�AGE•Wt ERlk�y ` E.WTE OF EtiiTN rra+►ar.rw� IYra) Se. Y09 O�YS Sc.�iUtiR3 MryS Philli s, Nebraska 83 • � � Ma 23 1906 a.socuLL sfcuwtr NuwE� a vuce oF oFArn - Hosrrrw �J riprwr o Ewa�q.er O oo� . 507-38-6367 s�n� o�•�o� nw�.�+o. oo.�.��so.�•r, Ca FACaliY-!WM Ir�01BMIMr.Mr�1rMr10�rM1 �C C(iY.TOWN OR LOCATION DEAiN �b WS10E CITY LYNT9 M.COUNTV OF DEATH Isprcy rN a�+J e8 Hall M,1�lIpENO!.STAT! 1b.COIMfiY 9C.CITY.TQYYN ql IOCATIpN Yd STREEi AND NUIMEH (nCAiOey ZO L100q N��MS+OE CR�171YT9 (SplCy YM P�No/ Nebraska Hall Wood River RR2 aox 225 no � 10.MCE•1�.0.WNY.lMCkMw�e�nM�Ewl 1�.ANCESTNIIN-¢JIMIRW��eKtiM�NM1MQ.! 12 WIMMEO.NEVERW111ME0. t� NAMEOFB►OUSE f��M��Y��W�Y! . , � MeJ/�+�1� (S�e/H WIDOWEO.WV0�CE0ISOrtq'1 white German �0 marxied Helen Mailander tNIJlUKOCG{/�ATqNKYMfNp�Mwwamyna� ��e uwoofsW�rts�wou�rn+r dwrW�K w�n/wMM Ew�r�wY a 6Ka�ar)lattl � t'�aMM 1�-�a i•1 Owner - Mana er Gas Station ' 1 eaY . . Il FAiI�l1•NM� FMt1T MIOOLE N�T IL MpT11ER.MAIpEN NAME iN1ST IIIOOIE WT r Neal DeVore Au usta A. Kadin 1�.WA5 OECEAtEO EYE11 N V�AM1E0 FQII�ESf t� Wf011MUM7-NitME•NAKNiO AOMESS 157 Ef 011 R i.0 NO..GTY Oi1 TOMM.STAT ZM) "_ 1r...e...r�1 lr YM.!'»�r�ns aw�e1 wvx.wl no Helen DeVore-wife-RR2 Box 225, Wood River. Ne 68883 - lpa�{JIWILC�Ittlbww��1 20�.DAfE 20e.CEYETEIIYOIIGIEWT011Y•MI1ME �00.LGCATql1 CrtYp1TOWN lt11TR ._. OOnYM� ' Burial Au 17 1989 *�estlawa Cemeter Grand Island Nebraska ; ' Zf.E •=IOMI1 i YCE1fSE NO. . �I� 72 FUNEWLL NOYE•N/M�AIID ADDt1EA ISTIIEET OR IIF.D.NO.C17Y OR TOWN. ATE 21P) -- �C A fel �neral Home Wood River Nebraska 68883 � 'Z!. Mr�ONTe CAUt! (ExTER ONLY oNE G ►ER UNE FOR I�L(0�•,,µL kl) I kiWVY OMwMn aAN r+a e�w� . '� �A{V,�,•�.I� ��r / \, \�vV{��r \ I ` •�� f�l OVE TC 011 AS A CONSEOUENCE OF: n` ' _ _ : WMVtl MMMn OMM Y�OOIMn � . � �tFW11oSC��i C V iA�S CUL�ML �?c ; .��?�S _ _ ` �� ouE To.oe�s w�lEa,enGe oF: i w.roy e.�...�a+.«.�a w.u, � � � � �IVY� � e14lj.i � OTME11 SKilKlGYfT CONO(IpNt-Cai6rar 10 A��Oul iql nIWO VAHT W 1�FEAWE,WAS TNERE A Z�.AVfOPSY 25.WA9 C IB�Ep11pl1pEDN�T10Y�YEOIGII •'� ►� � PREONANCY W TtfE►AST�MOHTMSi (�O�) /�y � NG7 � `� YN� No . 2�a ACGDEMT.SUIC�E.MOMGOE, b0.OATE OF M�LfURV �Ma,qy,YrJ Ztc NOUR OF YUUR11 210.DESCPoBE►W W INJUf1Y OCCURRED . 011 PE110r!(i (S�a1�9 �. ...�-� . {�.lµMY AT WOIYi 2Q./MCE QF IN,IUqY•Al lpey,(�rtNl,hGpry, 2i4 lOG1T1pH STREET OR 0.FD.NO. CITY OR TOWN STATE • �ory YM ar u�e�6��p,Me. (S�Ny/ �` . � I7a OATE OF OE11T11 (Y0.Oq:Yy 2M.DATE SIONED (Ma Wy.YrJ 2�0.TIME OF OEATM s g-I�-$Q a �• rrs a �o �ro.o.�:r•1 27e TutE Of rn ��Y zec.rnoaoin+eeo oe•o rw.ar.r�� zse.Aa�w�n� n�1 � � � �- 7:a0 `� �� !7t T�N Mr M Ury YN OrO�MO dW fN s�� 2M On M WU W 1tanlnaeqn�n0�p nw�YOn,n nyr pprYOn Malh OOCUn�O N OMM�)rML � b Y'M.0aM�n0 p40�ab Gw b M cauN�f)NNO� ■WT WqT�M� pK OIpTOMCCOUlE COtR TIH 70a NA9 OR T�$SUE OOMATIOt+BEEN CONSIDEREDI �OD W/45 COHSENT 6fLiHTE01 O Y[S �MO O UNKNOwN O YES �+0 O vE1 O NO �1. Al10 AOONESS OP CEIIYKIER(FMYSiGW.Cq10NEH'8�MYSiGW OR COUNTY ATTOIWE�/I RYp a CmY/ :•S�eyE.n I:..,.HusEn' I�ID. 908 N Howard Av. Grand Island Nebraska � au�asr� �o�re aaeo ev aeo�sTau+ nuo.o.r n� �� 3 0 �989 • i 10� Exhibit "A" .�.�. �'� l_ ' l- J � � . � . �.�6 � Y.. , � �