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A06802015 <br />This is a true and correct copy of the official record on file in the Office of <br />Vital Statistics, Topeka, Kansas, certified on the date stamped below. <br />2015 NOV 18 AM 08:16 <br />201707163 <br />Elizabeth W. Saadi, Ph.D <br />State Registrar <br />Office of Vital Statistics <br />Department of Health & Environment <br />It is in violation of KSA 65-2422d(g) to "prepare or issue any certificate which purports to be an <br />original, certified copy or copy of a certificate of birth, death or fetal death, except as, authorized <br />in this act or rules and regulations adopted under this act." <br />CERTIFIED COPIES WILL BE PRODUCED ON MULTI- COLOR SECURITY PAPER. <br />