|
ictr
<br />xYii
<br />I
<br />A I
<br />4
<br />49
<br />k 4
<br />,aaa
<br />,"r il�SSg
<br />.M1W i
<br />s S
<br />atc(�c� gE
<br />I yq
<br />1
<br />0 siY' i
<br />}} Iia
<br />114 �� � ppaa,(�( 1
<br />b
<br />ry
<br />41
<br />4
<br />t 31
<br />k
<br />81N.3„
<br />.,
<br />x ¢ 1 k / 11 I IY \
<br />Y '•Q\ 0 Or I k ¢ ( 1 a1
<br />k \ / \ 1 S Z 111 I
<br />"^e 1 @ 10 10 \ r
<br />\ r v.s 1 1l r ns �
<br />1 4a1u1 Srie�rrlx en3�`33@ 11 f SI e�C. 11w A ry aa+ �
<br />y����3��A��ri �es3lt�raam0a \Z! A,1dlA1�e�%Idlaa b�nn r Ir„/a.o.�A 1i
<br />STATE OF NEBRASKA
<br />sa#p I:aryyygla6sFa .xa�RIfTG.$.'(((IlIl59an agG6yyyANl a :Y &3i(((I)IDS?a ,, rvirrynpsll
<br />Se'.;•r .. r, .saAT�i.:Y - _.->)C3'r.W.'cn ,t5.+'.'�4.:� f. �... ... ....
<br />J�yp9m,
<br />91 ��
<br />1(Gitaelsdiuv$�11i�al�a��lt�llyiInVMJ Aiiliiie�a�r��(((a44!LGti
<br />4Ye lit (4 aver `t tgYy�aaii`IF�` tt$4.v )govt” igf((t4e45t12
<br />Ir4�lle'�11,
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF S TA TE OP NEBRASKA, IT CERTIFIES THE DOCUMENT BELOW TO'
<br />BE A TRUE COPY OF THE ORIGINAL RECORD ON FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND
<br />HUMAN SERVICES, VITAL RECORDS OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS
<br />OATS OF ISSUANCE
<br />9/28/2023
<br />LINCOLN, NEBRASKA
<br />SARAH BOHNENKAMP
<br />ASSISTANT STATE REGISTRAR
<br />DEPARTMENT OF HEALTH
<br />AND HUMAN SERVICES
<br />STATE or insiAssit—frirallIIIIIIraf'gratis
<br />auarlu aE viral STATIS111X
<br />CERTIFICATE OFTM
<br />NiIoaIE INt4T
<br />Caeeors £1I(.i.L lembuea
<br />.off-1.dIlbikley
<br />OM Of OWN INN. ON. V.(
<br />Oct. 11, 1982
<br />o•
<br />w 1 tW f UN 1 ON O9s,r.1as 190 0112101 . 4
<br />mos.
<br />wow
<br />oAtrs
<br />"UM,' wN�
<br />Sept. 15, 1912
<br />sdl?.T4stC �"NaeTw�i�grT awalA.&cu llTIONIGN, rfwlr)M�l{.Iweawi
<br />•(wa(N'■s WA row i(wNbdl •
<br />to], Ch ade.La- .te BeLoree.t.L.
<br />N
<br />IaSOF EOEwe01MIVNCUNIT1<Oro(ATN
<br />104. 1'r! I r 11021..1
<br />/IOIP
<br />mom 01llU..Tf411g C.**40r (Nast iseNM.r, 10 Noir. onwar, lrwrwao.
<br />shoo/APO •190410.40 ChoPorkwilanc 11%. Iwo*,
<br />,.a.. / 372 blalrtwt IA.
<br />1arr. TOIWNattiota/toot stair AND NUslsemAinla!
<br />3T. G10 0 ratiet_1s+. 1312 bia.Lrut.t
<br />'AAA* NKr
<br />LBf II,•
<br />w1WMMNT- -E lr is>l r-1lnl*DNC ACO$ anent on *As Na. ar, al IOW.. Tuft an
<br />T. Chan1j#.te. r_efebevtg-r i..e.- blood Zi -vex, llelrit. 83
<br />=minim ei. CIVIA*TGN.—NOTE LOCATION PIT OETOWN
<br />�rN►E slfc 'N II.E. NUNES KNOW
<br />COUNIT
<br />ININO! PTV WAITS
<br />(Specify Val «PAW
<br />11,.:..(LQ,A
<br />tor. 10T 151 82„,
<br />=MA. alit, ir,
<br />.7.u.`.hl��a6"tW.•rly."
<br />11,=7""'"
<br />Ts.
<br />Rohe
<br />1101112
<br />:Ng. NN'
<br />2O. bland, nor. Wood Zia
<br />NE
<br />NuAL 110M� ...._.,, T ...... NOT Oe .1.O N.. OTT ae ToWN, MIL W1
<br />zT,
<br />!Wel. 3wI 4a:L l o dam,,'£ "�n' 883
<br />016o owe. doge -d yolas sod i. W lb
<br />2411,
<br />,)/X94.4 TAd. it Thn
<br />G. Am bate el aaeY.d....*, i okigyikA k R eplier iuN
<br />Ar err.:A.w wi}Iw.J J.. s. nWyei
<br />'OSCAN w .I7{p1TT AkTerIPOI11400 401440i
<br />award Jensent.Trs Deputy County Sheriffs! Grand /eland
<br />s7. l�T C
<br />Ca -tone zy. °cal -ti Lan.
<br />To. 8i Aliidirs4sieuiricsor:
<br />tm
<br />(071U OW ONE COOS PO UNE roe (*.PM MOW/
<br />01I0 TO.; 0e#,s4h4eaueuemcz
<br />046.# so.wb.Nq w Nook kw.
<br />al.11wMe7s110e1n o.I . a
<br />�iwACE r
<br />aIMAM f ..0..Mi
<br />Nave Of twuar
<br />— w Iea1. IWwy anat. l d..7.
<br />OR. Ispldh/
<br />iltINOIST
<br />T« O 14.
<br />03Caeewow Paull
<br />MINIM
<br />Maley kw et Nei
<br />,. No
<br />/q / 9a.
<br />. sua.edd(u.ta :.
<br />LNe..I b.l.r..re.d fYi
<br />e
<br />1
<br />IMMO
<br />120N / Tye,,
<br />E0.
<br />0
<br />
|