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OL
<br />OL
<br />LEGAL DESCRIPTION:
<br />The South Thirty Eight (38) Feet of Lot Three (3) and all of Lot Five (5),
<br />Block Nineteen (19), University Place, an Addition to the City of Grand
<br />Island, Hall County, Nebraska.
<br />MEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMANSERWCES
<br />SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL REC0R()n0N;FXLVEWTH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISICS SECMN, WHXWIS
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS.
<br />A zi
<br />DATE OF ISSUANCE
<br />Af - tooftft�
<br />JUL 2 0 2000 ASSISTANTSTATE REQISTRAR-_:�
<br />LINCOLN, NEBRASKA HEALTH AND WORIA k-SOMCES40STEW -
<br />z 0000 (0 3i"?
<br />94 STATE OF NEBRASKA — DEPARTMENT OF MEAL r"
<br />BUREAU OF VITAL STATISTICS 9 5 i 2 15 5
<br />CERTIFICATE OF DEATH
<br />k*(xxE MST SEX !'u_�DiAT>; W�';;
<br />May Belk Robe Female October
<br />29.19"
<br />A. CFTY MID STATECFNRYM 'VAWFUSA r Cdt"w
<br />Aftwe, Nebraska
<br />Se MA • L.0
<br />70
<br />0
<br />YEAR
<br />—..D. 7.—,— —
<br />-
<br />1 December 20, 1924
<br />56 1
<br />�C-R �Tw �
<br />"&29-17S7
<br />1
<br />706Md"
<br />I —
<br />_ PLACE
<br />N PLACE OF DEATH
<br />tKISP`TAL. T.Fr'
<br />_: [D
<br />EEII EA 0.0�
<br />( El ODA El Ow- i_ A,
<br />❑
<br />III, FACWFY•N�
<br />Park Place Nursing Center
<br />ft CITY TOWN OR LOCATION OF DEATH
<br />dd NSNDE CITY LOATS
<br />IN COUNTY OF DEATH--
<br />Grand Wand
<br />Y. [N N. n
<br />Hall
<br />9A FIESIDOOM - 51 AT[
<br />COUNTY-
<br />9kC CITY TOYVNORLOCAfION
<br />96 STFwi—T—Amb- R Wkbwv '4P Cow
<br />INSIDE CITY k"TS
<br />M
<br />C.
<br />=
<br />I"
<br />Hall
<br />Island
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<br />141kUSUPAOCOWATION
<br />VC;Zn"erwAaw'71'0'"p`eerator
<br />OF BUSINESS &NOUSTRY 'IS EDUCATION
<br />Beauty Shop f- Tr . Sw ,'Y to 12) C~1
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<br />CO
<br />LEGAL DESCRIPTION:
<br />The South Thirty Eight (38) Feet of Lot Three (3) and all of Lot Five (5),
<br />Block Nineteen (19), University Place, an Addition to the City of Grand
<br />Island, Hall County, Nebraska.
<br />MEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMANSERWCES
<br />SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL REC0R()n0N;FXLVEWTH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISICS SECMN, WHXWIS
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS.
<br />A zi
<br />DATE OF ISSUANCE
<br />Af - tooftft�
<br />JUL 2 0 2000 ASSISTANTSTATE REQISTRAR-_:�
<br />LINCOLN, NEBRASKA HEALTH AND WORIA k-SOMCES40STEW -
<br />z 0000 (0 3i"?
<br />94 STATE OF NEBRASKA — DEPARTMENT OF MEAL r"
<br />BUREAU OF VITAL STATISTICS 9 5 i 2 15 5
<br />CERTIFICATE OF DEATH
<br />k*(xxE MST SEX !'u_�DiAT>; W�';;
<br />May Belk Robe Female October
<br />29.19"
<br />A. CFTY MID STATECFNRYM 'VAWFUSA r Cdt"w
<br />Aftwe, Nebraska
<br />Se MA • L.0
<br />70
<br />0
<br />YEAR
<br />—..D. 7.—,— —
<br />-
<br />1 December 20, 1924
<br />56 1
<br />�C-R �Tw �
<br />"&29-17S7
<br />1
<br />706Md"
<br />I —
<br />_ PLACE
<br />N PLACE OF DEATH
<br />tKISP`TAL. T.Fr'
<br />_: [D
<br />EEII EA 0.0�
<br />( El ODA El Ow- i_ A,
<br />❑
<br />III, FACWFY•N�
<br />Park Place Nursing Center
<br />ft CITY TOWN OR LOCATION OF DEATH
<br />dd NSNDE CITY LOATS
<br />IN COUNTY OF DEATH--
<br />Grand Wand
<br />Y. [N N. n
<br />Hall
<br />9A FIESIDOOM - 51 AT[
<br />COUNTY-
<br />9kC CITY TOYVNORLOCAfION
<br />96 STFwi—T—Amb- R Wkbwv '4P Cow
<br />INSIDE CITY k"TS
<br />Nebraska
<br />I"
<br />Hall
<br />Island
<br />2024 N. Sherman Blvd, 68W3
<br />Y" ER ❑
<br />-[Grand
<br />M FACE -M0. Whft 11Wk M.n.An 00i1 I If, ANCESTRY4 9.. kahwon. Max— Gerrmn wl
<br />aftl Swo"
<br />White American 0
<br />12 MARRIED 13 NAME OF SPOUSE 1"* 0" -W-1- .-,W
<br />ra�7( C��Frank Robertstpe
<br />141kUSUPAOCOWATION
<br />VC;Zn"erwAaw'71'0'"p`eerator
<br />OF BUSINESS &NOUSTRY 'IS EDUCATION
<br />Beauty Shop f- Tr . Sw ,'Y to 12) C~1
<br />Jobn Tockey. Blanche Callan
<br />WAS DECEASED EVER 14 US ARMED FORCES? 19- INFORMANT. NAME
<br />R _�Aiw
<br />Apfel-Butli
<br />an rUwAk MOVE
<br />1123 West
<br />L7, NAECU/El
<br />PAM
<br />IM
<br />DUE TO. OR
<br />IN
<br />01A To OR
<br />_II —
<br />OTHE A SI- GN
<br />PART 7
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<br />D 40. G1- OR TOWN STATE, 2)M
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<br />IhUURV 1W 'U, nj : M �K" OF 94AAY
<br />I il CEMETERY kAAAE'_
<br />CEMETERY 4 12 _".. I W9SUpfflimlemorial Park Cemete
<br />)R CREMA TORY LOCH I ION
<br />Ory OR TCqV% iTA?f
<br />rand Island, Nebraska
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<br />❑ M---ft .g..- Y" El -E]
<br />27A DATE OF DEATH W CW Yj DATE SIGNED _rW D.Y r.l 29b 104 OF DEATH L,
<br />October 29, 1995
<br />27b 9ATESPGMED /w D", Y11 121c WOFMATH 2.c PRONOUNCED DEAD ilWb OW 2t4 Yj 2 PRONOUNCED DEAD
<br />A0 /0
<br />October 31, 1995
<br />1 6:25 p 9
<br />T. ft bw a , ft �.Fxs -
<br />PAWd I" up— 0.- —w
<br />I 1w w" ft* a
<br />�w T a""
<br />M DOD TOSACCO USE rC%TF &jTE 10 THE DE HAS OFWAN OR TISSUE DONAT" AEEN CONSIEVIFIr 99.0 WAS CONSENT Gf"TOP
<br />ElYES NO UN"I I OWN YES Yw'
<br />C3 NO
<br />11 "It AND SS (N CIERMIER 4-H
<br />AM MOO"O"E"S""'SCINNICACQUft" AnORNEYi rTgwwPv*V
<br />Dr. Tboma%' Wernr 2444 West Faldiey Ave, Grand Island, Nebraska, 6M3
<br />PART N IF ic.MA(f * _45 WAS IMA AfFfOW 1) -,j 1ffl.r.C_4
<br />PRE _-A-_1 NI HE "s I I me" THS'
<br />FkAWICAORCONO.C.-
<br />-"d 0*-I.Rk* '.ow oiA'Ay ocrL_*'D
<br />❑ — C3
<br />__V A
<br />A;V
<br />IOCAIK-A
<br />❑ M---ft .g..- Y" El -E]
<br />27A DATE OF DEATH W CW Yj DATE SIGNED _rW D.Y r.l 29b 104 OF DEATH L,
<br />October 29, 1995
<br />27b 9ATESPGMED /w D", Y11 121c WOFMATH 2.c PRONOUNCED DEAD ilWb OW 2t4 Yj 2 PRONOUNCED DEAD
<br />A0 /0
<br />October 31, 1995
<br />1 6:25 p 9
<br />T. ft bw a , ft �.Fxs -
<br />PAWd I" up— 0.- —w
<br />I 1w w" ft* a
<br />�w T a""
<br />M DOD TOSACCO USE rC%TF &jTE 10 THE DE HAS OFWAN OR TISSUE DONAT" AEEN CONSIEVIFIr 99.0 WAS CONSENT Gf"TOP
<br />ElYES NO UN"I I OWN YES Yw'
<br />C3 NO
<br />11 "It AND SS (N CIERMIER 4-H
<br />AM MOO"O"E"S""'SCINNICACQUft" AnORNEYi rTgwwPv*V
<br />Dr. Tboma%' Wernr 2444 West Faldiey Ave, Grand Island, Nebraska, 6M3
<br />
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