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<br />WHEN THIS COPY CARRIES THE RAISECtSEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OLD HEALTH. IT CERTIFIES THE BELOW TO BE A TRUE. COPY
<br />OF AN ORIGINAL RECORD OX FILE-WITH THE STATE DF.FAR M1MT OF HEALTH
<br />BUREAU OF VITAL STATISTICS, WRICH. IS THE LEGAL DE; ORMRY -FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE o
<br />OEC 2 21W STANLq— S. COOPER i-TIRECTOR
<br />LINCOLN, NEBRASKA BUnA11: f1 ., gA4' STATISTICS
<br />89- 104990
<br />s�� aF rr�u�AS�u►_O�rARTraIT o��>;�
<br />FXMAU OF VITAL STATISTICS
<br />:.C4ERTIFICATE OF DEATH
<br />DECEDENT. -16wt FIRST tAv
<br />SE2 DATE DM", (LAer,. 0", Tr)
<br />Frank Tav --Iw` Shull
<br />Male Dece,`,,E=. 11, 1987.
<br />i 11,
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<br />Arspe, Iowa ''
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<br />WIDOWED OIV ET•.-i5p•eAlT,
<br />Marrie `;,paula M. Bussinger
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<br />LilaaMi16.E -S:ATB COUNTY
<br />CITY. TOWN 00IOC'ATFGN
<br />STR11TANDNUMRER WSICE. TYU,A:`S
<br />Hall
<br />113C Grand Island
<br />1720 S. Spring Rd.
<br />raska IS►
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<br />•A.N t -HAAAE FIRST MOVIE LAS/ MOTNtR- MAIDENNAM! FIRST MIUM
<br />Marshal -- Shull Jessie Leota Baker
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<br />WAS OEC 1=1 EVER IN US -ARMED FORCES? INFORMANI- NAME - RRIATIONSHI►- MAKING ADDRESS IST411104 R10 NO GTr ��Qp�v N, tA11. t+F)
<br />Rw. tee. W .wcl If q •/ NE • VIN" ,E Yes. t!'+ ri W!TV45 WWI ,#Paula M. Shull- Wife -1720 S. Spring Rd. -Grand stand,
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<br />14 Il%87 ClM 1811 ONCRIMA'Oty -"LAM! LOCATION CITY OtTOWN STATE
<br />10,1116. Grand Island, Nebraska
<br />Burial Grand Island Cemetery
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<br />GNAU • IKENSI NO. 2. p FUNEIAL, H+�illi - NAMI AND ADDRESS ISTtNIT W R / O NO. C+IV OC TOWN. STAN. EIF)
<br />Apfel- Butler- Geddes 1123 W. 2nd, Grand Island, NE. 68801
<br />aF VIA D. /. v., — DATE SIGN D (M. OaF. V.) HOUt OF DEATH
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<br />12 -11 -87 `YO
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<br />Raymond Cenant M.D. 2115 14. Kansas, Hastings Medical Park, Hastings, NE. 68901
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<br />' D EC 2 21987
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