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90-i- 109512 <br />WHEN THIS COPY CARRIES THE RAISED SEAL `OF THE NEBRASKA STATE <br />r7 - DBg! T_ aF_.SE1 T11,._ IT CERTIFIES THE BELOW TO BE a , ,TBUS COPY <br />OF AN ORIGhlila RECORD Oh 121tt _ WtM THE STATED <br />- BU1JEAU. OF VITAL STATISTICS, WHICH I$ TH& LEGA DF.fOSITOgY <br />VITAL RECORDS. <br />• 'DATE OF ISSUANCE <br />i . a 190 STANLEY 14` A �PERf DIRECrT�R <br />LIiiCOLN> NEBRASKA BUREAU OF`VtTl <br />ff�� _ - - - - -- -- - <br />sum"OFMALSTATt> it 0-5928' <br />j jj��VTT�� IV <br />VV � — - <br />,cmirCAiE CF <br />� oEtEOENT NAAE 2 GE7t � DATE OF <br />itHST IAIDOIf LAST <br />George', Hamilton Holder <br />Male <br />DEATH rAb�n. LW rAr1 <br />May 20. 1990 <br />.. arr AW STATE of ■TTN AAr� usw, r11.0 ca1.+ri <br />,ry <br />k AGE -tar , <br />tvK)S5 sa Aas ors sc HouRS <br />o DATE OF /RTH (A,Yrt DO Y„a <br />wAs Septenter 4., '1904 <br />Tonganoxie, Kansas <br />7 SOCML "CU1,TV MATER .. 4 MACE OF DEATN .140 Q &O.Mn :: ER P.GCa = 00A <br />• 1 506 -20 -2723 -- <br />1►1 R+>•N 11w :: RMOiaot i OQYr (S�G'hi <br />. <br />oL fALRlTt •NAtM (IAreDAM,t it, J/wtrra n.ttlwl <br />k OF TOWNORLOCATIONOi DEATH r tE eVS!DE MItIT Y COUNTV Or- "ATM <br />des Hall <br />St. Francis Skilled Care <br />Grand Island, Ne. <br />W IIESr0E1tCE•STATE �f01X1Tr <br />.c cm. TOWN OR LOCATrON m ET AND NUAlER Rncndr p Zm CoaN 9. ,NSAE Cm LONTS <br />rn awr <br />`"es <br />Nebraska 8a11 <br />Grand Island 137 North Carey <br />PWiG; Z AMEED VER ' <br />Ia as W- Wt r <br />tmerican <br />,s wulEasPu nmApiwetAAro <br />Margaret Wagner <br />Marc <br />14W USM A_F_ VATIM MIA UW OP * OM *0aV ftW <br />Tsa KMO OF W. SINESS INDUSTRY :3 <br />EL►�S.CdiMY(a -,21 C.a�iilt�a'!�1 <br />a/.,r,ttooAe1w11nW�W /�!� <br />Sales Bflokk r �� <br />Farmers Union Elevator <br />L, <br />to fATwo•RAM pp" WME <br />IAST tT AgTHER -YAWN MUM <br />Prt9T - WOME LAS7 <br />Emma Burch <br />Names A. <br />Holder - <br />.Edythe <br />- - <br />- -- <br />. wcns..rrt . MAI/E . MARINO ADDRESS <br />!STREET OR R i 0 NO CCTV OR TOWN. STATE PP) <br />,swNMS�v..c��.. --- - <br />tramr,.al t,piA(♦1YtgrAMMANbAA-frKM) <br />Larry Nnl dar 125 11-- ('ara Prand t el and 6$AAt <br />rtv rr rrr.A. STATE <br />Bivial - Ma 24 1990 Westlawn Memorial Park Grand Island, Ne. <br />11 R - SN'rIMTLYE CM 6 27 iUNERAt M01E •NAME ANO AOORE55 (STREET OR R i O NO GTY OR TOWN FA%w1 <br />Apfel-- Sutler- Geddes 1123 W 2nd Grand Island, NNee- <br />- _ _ -- .e..ren �,...� due rusE PER 17NE i0R rAi te. AND cur _ rAYYA1 Oie..Rr anw �ti e..,, <br />u <br />rntwn er.wn ortr W Qf� <br />OUE TO.ORASA CONN WENnOP <br />PK WANV N THE PAT T VWHS+ lSDK r d AIO! ES1rAi1c / h Yes O a PART R W HO <br />T 1SOrc+b vAi a Att � aka eurero. Me �Srich� I ' <br />1TA n <br />DATE-OF OWN (W D.7. e I tae, GATE s�++e0 rW OAi r�, taa rMc OF OEArH <br />May 209 1990 <br />s F, trk Vi/DNOl.7rCa07FAD 'W C.Y •' �aiT PACN'JU4CED DELI i,4^JI <br />1Ta we wro pb Mil 1)c MAE OF DEATH <br />Z I . o 6:40 <br />are TonYr <br />Wail caner am .AY1Qf n.a 2!. Ora. wsI of uA * -ur.W W4 3, -..r;r ♦._f 00+P - -go v <br />ft <br />C46"11 ilri0 a <'v rme css AM OW. W :u. a :.n <br />. S. V AW <br />I �S�W�. AN Td. �. <br />2M Dial OMCCO USE CONTAIoUT 0TNE pEATN' k. HAS OaBAh OR,Tnss E DuaA•,Or.E.E%CONS<DEAEO' iXt WAS CO.SE4T i,7A.4TE6• <br />�YrE3 �tRi ❑ YES )e,ND YES -D <br />31 NAPE ANDADDAESSO.CERYJ1ER tPHYSiCAR ORO PSPHYSKANORCOUNTY ATTOatiri frrv*&P-' ' <br />Dr. X. Hrnicek 729 North Custer Grartd Island. Neoraska 68803 <br />,)i: DATE FILEJa, Pi- :,51k.k =1 Cal Y�- <br />.. <br />its REGI$TIw. 1 . <br />LLot Six (6) Block Thirty- seven (37), Packer and Barr's Second Addition <br />to the City of Grand Island, Rall County, Nebraska. <br />