|
IVHENTISSCOPYCARRES TIE RAISED SEAL OF THE NEBRASKA HEALTHAA1b f9WN8ARWCES
<br />SYSTEM ITCEII The BELOW TO BE A TRUE COPY OF THE ORIGINAL _ F#EWTH-
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL 8TATI8 1_4 WI4I
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS,
<br />DATE OF ISSUANCE _
<br />F E B 10 2003 200400161 ASS18LVfT
<br />LINCOLN, NEBRASKA HEALTHANONIf '9Y8T6t1
<br />�11 LIT
<br />STATE OF NEBWA - DUSEI ffNT OF nl AND HUMAN SE0.YI�S:iNANCE Al AT
<br />�TAt aTAM rs - 13
<br />00915
<br />CERTIFICATE OF DEATH
<br />I LICILIxr NAME INr
<br />ANTYLE - LAS
<br />L.
<br />rE DF OEwm 0.411 w. vrl
<br />Sharon
<br />(NMN) Tuma
<br />Female
<br />January 19, 2003
<br />n'ANC ,A,EOE NIHrH 1-A sA. —A—,l
<br />9 I V
<br />xs•..
<br />B. AGE u nIW
<br />- %
<br />FACE
<br />DEL IeE Het IN,.RY eee.RRED
<br />0 .,I,- AN. H — GAP .NA,
<br />Palmer, Nebraska
<br />4:00. pm
<br />"T 1 48
<br />$, RON DAY
<br />"I 'NS
<br />February 8, 1954
<br />,. SGCIALSECUPnYNUMBEA
<br />❑arvrmm
<br />AR 'FACED DEATH
<br />_-
<br />508 -78 -1850
<br />u .. va q ��r
<br />._� a�ON .r
<br />RDSPITAL ❑ IFARIA. OTHER ❑ N..,,NgHN x
<br />_ ❑ L .1-AA, — o HAPPY-
<br />ALIL ,M., w,M, ,Ace ,Ab M
<br />6444 Schauppsville Schauppsville
<br />❑ DF
<br />A s"
<br />❑ Deea' rr
<br />-__.
<br />& en roWNORLDCARDIGFDEATH
<br />_ —'
<br />M. INS1DECm DUI TS
<br />&GWxTY DE DEATH
<br />Wood River, Nebraska
<br />Y., ®NN ❑
<br />Hall
<br />`Sgt
<br />-i, xESIDEricE -s *.TE m cGUxl.
<br />x. THI TDWN ON 1 oGATmx
<br />a, STAIRTAxDxFMNFn ,M.ry xryrrrakr ve rNSINeaTYUMrS
<br />Nebraska Hall
<br />Wood River
<br />6444 Schauppsville I Y,: ❑X Na❑
<br />p W .ever me =m W xv PNLER7 eq a av, AN— G mA AI E—XAPPIED
<br />_ _
<br />❑ W ED RA 1111 n k rvrt w e S
<br />Pe """"'Y White polish
<br />AA
<br />Germ
<br />James Tuma Sr.
<br />n M
<br />January 19, 2003 8 4
<br />- -C rrexwt.P.. MP. oWirVmvN
<br />o FsuAL OCCwnvox m
<br />I axe OF IRCEP Sa INDUSTPV
<br />EDUCATION IsPa<�n NPw ngl.Ng.ea=NPa.Nel
<br />Y ...,';IAA Suraica
<br />St. Francis Ned Center
<br />EN "e'Ge<— IN, "I LxI,N, N.,N, -r —
<br />"m
<br />Sterilizationem to ee
<br />$�'�
<br />16 FAiHA-1.F FPS, MIDDLE
<br />UST r /MOTHER
<br />FIFSI -
<br />IODLE NAIpEN 3UPN.IME
<br />(dec) Clarence
<br />Michalski
<br />Lucienne Dethlefs
<br />— was DECEASED EVER'A Vs..."'.PLesv
<br />wFrnuaxr. NAME
<br />NoP
<br />9 OBALLO USELW,PIBVTE TO THE UEATI9
<br />IOT❑
<br />James Tuma Sr.
<br />x, GHnxrm+
<br />W x mAAxi APPLING ADDRESS fSRPCF7ICF1FFF p NO, CITY OPiOWNSTATE Z1i1
<br />❑ YEE
<br />6444 ppsville
<br />Wood River, NE
<br />Kay Tracy, Deput Hall C my Attorney, 231 S Locust, Island NE
<br />ONSch
<br />xa E. - s U«E IC AS' NO
<br />�j
<br />RGrand
<br />4S AR pa DAP HL
<br />°- .
<br />068883
<br />_,_
<br />�OR�FM.TORY xAMF
<br />gjj D „w ❑,N.N.,I
<br />Jan 23,._
<br />Elmwood Cemetery
<br />v ax A, FIRMA, -xA J cobsen-
<br />COMETEmoROPEMATOPYmcATION
<br />.200
<br />- CITY OPipMI STATE
<br />Greenway Funeral Home
<br />❑O'.A ❑a °' "°
<br />St. Paul, Nebraska
<br />., "I ISTREETFR A FD NO LNYDPTDWN.TATES,P,
<br />411 "O" Street St. Paul, NE 68873
<br />IAAF
<br />cu.rmwSE IEUIeP Gxv OxE CxusE PEP LME FOP �aI Z..rvp m, mwrYa,wLP..PNm,a.e ear.
<br />LI
<br />Gunshot wound to left chest immediate
<br />OVE TO. GP ASALONSEOUENCEOf � Imervareaµeenmmamttnn
<br />SHIL IO.OR AE A Dex3FOVFxLF OF
<br />I mural WV.wnPmm am Wmri
<br />OIHEPBIGNIF,LANr CONLOCA S- emeiAOnzanelGRAl...enNWIMMa4E I
<br />HI AVT-11
<br />A, All HE IOL
<br />PA PREGNANCY
<br />N T
<br />ExAM
<br />II
<br />I AgnO JI I
<br />MY
<br />xs•..
<br />xo. DATE DE INnxr rxn.Da.m
<br />HwwaF IP.
<br />DEL IeE Het IN,.RY eee.RRED
<br />❑ D.e..nr,.,
<br />an 19, 2003uLE
<br />4:00. pm
<br />wound to left chest
<br />M
<br />gunshot
<br />❑arvrmm
<br />s0. ik¢e WCA -F!Y iA M1me. ran. Arm raspy
<br />'xM,
<br />ip,. L.A'. STPEET OP aF C. NO C,rYDBTGWN S1n1E
<br />u .. va q ��r
<br />._� a�ON .r
<br />�, ❑Ne [�
<br />home
<br />—
<br />6444 Schauppsville, Wood River,N
<br />-_— -
<br />3G -o4rE BIfiNEO -- , zBC THE OF GPATO
<br />x RATE OF ,uo Oa. nJ
<br />January 30, 2003 4:00
<br />pm
<br />`Sgt
<br />�ae'AFe SlGxen mm ovr..n
<br />zm TAII-ISAIN
<br />xt Prronarncm DEAD Nro mr Yel . PrroxwxLEGDEAO ARI
<br />=Eg
<br />January 19, 2003 8 4
<br />tlgK
<br />M
<br />5 pm M _
<br />_ _ raargnil.vr'n TYNIn✓nerarn mewrm nr
<br />_
<br />eWNe,a e.t,�N,.P,xa.e..mM' ne I.A. —ANP.—
<br />$�'�
<br />PIAAAA;a"
<br />_
<br />=a.M"N.
<br />-De
<br />Co Att
<br />Ala
<br />9 OBALLO USELW,PIBVTE TO THE UEATI9
<br />IOT❑
<br />HAE DW3AN ON nSEVL UCxA x OEx
<br />VGxx„GE❑
<br />x, GHnxrm+
<br />MS n e0 ❑ uNFNOWN
<br />❑ YEE
<br />�I
<br />vE5 NO
<br />NATAL ITOGOf CEff— IPHONESAN DggxFNS PHreaMN OR COUNry AnMNEYI m "Pnw.
<br />Kay Tracy, Deput Hall C my Attorney, 231 S Locust, Island NE
<br />EG Si
<br />RGrand
<br />4S AR pa DAP HL
<br />61,
<br />F E6 3 2003
<br />Legal Description: Lot One (1), Greenwood Subdivision, Hall County, Nebraska.
<br />F
<br />
|