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<br />STATE OF NEBRASKA
<br />44i
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF STATE OF NEBRASKA, IT CERTIFIES THE DOCUMENT BELOW TO ,
<br />YBEA TRUE COPY OF THE ORIGINAL RECORD ON FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND
<br />h \ HUMAN SERVICES, VITAL RECORDS OFFICE, WHICH IS THE LEGAL. DEPOSITORY FOR VITAL RECORDS
<br />8
<br />tg
<br />3
<br />DATE TE OF ISSUANCE
<br />6/9/2026
<br />UNCO4.N, NEBRASKA
<br />2026044.09 ,_ .f eke f'
<br />SARAH BOHNENKAMP
<br />ASSISTANT STATE REGISTRAR
<br />DEPARTMENT OF HEALTH
<br />AND HUMAN SERVICES
<br />STATE OF NEBRASKA - DEPARTMENT OF HEALTH AND HUMAN SERVICES
<br />CERTIFICATE OF DEATH
<br />1.DECEDENT'S4NAME (FIr*t Middle, Last, Suffix)
<br />Judy lay Taffk .(AKA Judith Kay Tank
<br />4. CITY AND STATE OR TERRITORY, OR FOREIGN COUNTRY OF BIRTH
<br />NoifIf Nebraska
<br />7, SOCIAL.$ECuRITY NUMBER
<br />505-48-0660'
<br />5a. AGE - Last Birthday
<br />(Yrs.)
<br />85
<br />8b. FACILITY -NAME (If not Institution, give street and number)
<br />Bethany Home
<br />8c. CITY OR TOWN OF DEATH (Include Zip Code)
<br />Minden 68959 ..
<br />9s. RESIDENCE -STATE
<br />Nebraska
<br />ad. STREET ANO NUMBER
<br />707:Wttite Ave
<br />9b.000NTY
<br />Hall
<br />10a. MARITAL STATUS AT TIME OF DEATH ® Married 0 Never Married
<br />C] Married, but separated 0 Widowed 0 Divorced ❑ Unknown
<br />11 FATHER $-NAME (First;
<br />Glen Dedel
<br />Middle, Last, Suffix)
<br />13. EVER IN U.S, ARMED FORCES?
<br />(Yes, No, or Unk.) No
<br />F
<br />15 METHOO OF DISPOSITION
<br />Q Burial ❑ Donation:
<br />® C►emadon ❑ Entombment
<br />❑ RemoSal ❑ Other (Specify)
<br />5b. UNDER 1 YEAR
<br />2. SEX
<br />Female
<br />5c. UNDER 1 DAY
<br />MOS.
<br />DAYS
<br />HOURS
<br />MINS.
<br />8a. PLACE OF DEATH
<br />HOSPITAL ❑ inpatient OTHER ® Nursing Home/LTC
<br />❑ ER/Outpatient dDecsdent's Horne
<br />DOA 0 Other (Specify)
<br />8d. COUNTY OF DEATH
<br />Kearney
<br />9c. CITY OR TOWN
<br />Grand Island
<br />9e. APT. NO.
<br />af. ZIP CODE
<br />68803
<br />3. DATE OF DEATH (Alfas.:, Duly Yr )
<br />May 23, 2026 .
<br />6. DATE OF BIRTH (Mo., Day, Yr.)
<br />June 29, 194 0
<br />Htasplcs Floefly
<br />IN•1t+IS10e ctrf Lion
<br />YeS CINO
<br />10b. NAME OF SPOUSE (First, Middle, Last, suffix) If wife, give maiden name
<br />Gary Tank
<br />12. MOTHER'S -NAME (First, Middle, Maiden Surname)
<br />Neva Rice
<br />14a. INFORMANT -NAME
<br />Gary Tank
<br />16a. FUNERAL DIRECTOR SIGNATURE
<br />Stacie L Cook
<br />18b. LICENSE NO. J
<br />1495
<br />16d. CEMETERY, CREMATORY OR OTHER LOCATION CITY / TOWN
<br />Central Nebraska Cremation Services
<br />1Ta. FUNERAL NO ME NAME AND MA LING ADDRESS (Street, City or Town, State)
<br />All Faiths Furierat Home, 2929 S. Locust Street, Grand Island, Nebraska
<br />-- Gibbon
<br />1 CAUSE OF DEATH (See instructions acid examuEes)
<br />11. PART I Enter the chain of events. diseases, MJurts, or complications -that directly caused the death. DO NOT enter tannins( events such as cardiac arrest,
<br />mepbMery sweet, er vettkicular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if nsbQary.
<br />1 IMMEDIATE CAUSE:
<br />IMMEDIATE CAUSE (Thal a) Pancreatic cancer
<br />w . disease or condition resuMng
<br />in loath) DUE TO, OR ASI(CONSEQUENCE OF:
<br />BegwnHWy list condaio if '._b)
<br />11111IMatiliytathe cable tlsapd
<br />.R onllnae;
<br />DUE TO, OR AS A CONSEQUENCE OF:
<br />;6 Enter the UNDERLYING CAUSE C)
<br />'S (disease or Injury that initiated
<br />the events resulting in dealt) DUE TO, OR AS A CONSEQUENCE OF:
<br />LAST d)
<br />3
<br />18. PARTI, OTHER SIGNIFICANT CONDITIONS -Conditions contributing to the death but not resulting In, the underlying cause given in PART 1.
<br />Protein calorie malnutrition, pancytopenia, chronic diastolic heart failure, anxiety, multiple myeloma
<br />3Q 1F:FEMME
<br />❑ N9tpr*gfMnt*Methpaintys
<br />❑
<br />1/ Pe�pfl#klt lk
<br />*SO? deitgh ;:
<br />❑ Not p sgryat. but pregnant within 42 days of death
<br />:.Q Not.pmgnald,.but pre9rxtra 43 days to 1 year before death
<br />❑ Ult(inovirt If pro +sin rdllin nbr past year
<br />22a. DATE OFINA'I*Y{MO.,:Diy, Yr.)
<br />22d. INJURY AT WORK?
<br />C)YES ONO
<br />21a. MANNER OF DEATH
<br />E Natural ❑ Homkide
<br />❑ Accident ❑ Pending Investigation
<br />❑ suicide ❑ Could not be determined
<br />22b. TIME OF INJURY
<br />14b. RELATIONSHIP TO DECEDENT
<br />Spouse
<br />18e. DATE (Mo., 9ity1 Yf)
<br />May 26, 2026
<br />STATE
<br />Nebraska ..::::: .
<br />1.714APAid, :'
<br />688Q"['
<br />APPROXIMATE INTERVAL
<br />onset to*sf
<br />Months
<br />onset to dttalh:,.:
<br />19. WAS MEDICAL>EXAMINF. its
<br />OR)40RONER CONTACTED?
<br />® YES :.:.❑ NG,
<br />21c. WAS AN AUTOPSY PERFORM. eD
<br />® ❑YES NOlI
<br />21d. WERE AUTOPSY FINDINGS AVAILABLE
<br />TO COMPLETE CAUSE OF DEATII4
<br />❑ YES ❑ NO f
<br />22c. PLACE OF INJURY -At home, farm, street, factory, office building, construction site, etc. $pacify)
<br />22e. DESCRIBE HOW INJURY OCCURRED
<br />LOCATION OF`INJIJRY •STREET & NUMBER, APT.NO.
<br />I'
<br />n1
<br />o
<br />23s. DATE OF DEATH (Mo., Day, Yr.)
<br />May 23, 2026
<br />CITY/TOWN
<br />23b, DATE Slfi IEDISto., Day, Yr.)
<br />Mav:2G, 2026
<br />23c. TIME OF DEATH
<br />10:00 AM
<br />2311, To the lt%I Only tmow edge, death occurred at the time, date and place
<br />and dhw to tin Gamete) Mated. (Signature and TRIM
<br />John A. Craig, MD
<br />25.DIDTOBACCO ;USE CONTRIBUTE TO THE DEATH?
<br />YES p 140 ❑ PROBABLY ® UNKNOWN
<br />!. NAME, TITLE AND ADDRESS OF CERTIFIER (Type or Print
<br />John A. Craig, MD, 727 E. 1st Street, Minden, Nebraska, 68959
<br />28s:`REGISTRAR'SSIGNATURE
<br />21b. IF TRANSPORTATION INJURY
<br />❑ Ddver(Operator
<br />❑ Passenger
<br />❑ Pedestrian
<br />❑ °the((Speciry)
<br />STAyE
<br />24a. DATE SIGNED (Mo., Day, Yr.)
<br />240. PRONOUNCED DEAD (Mo., Day, Yr.)
<br />24b. TIME OF DEATH
<br />24d. TIME PRONOUNGEti EAO '
<br />24e On the basis of examination andlor investigation, in my opinion death obaaied
<br />the time, date and place and due to the commis) stated. (Signature and Tela)
<br />28a. HAS ORGAN OR TISSUE DONATION BEEN CONSIDERED?
<br />DYES 511 NO
<br />28b. WAS CONSENT GRANTED?
<br />Not Applicable If 26a Is NO ❑ VES
<br />28b. DATE FILED BY REGI$TRAR:(Mo., Gay, Yr
<br />June 2, 2026
<br />
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