|
i n,A$ saliillani P iAniiO Nam MIME9#,5fiL
<br />Alti141VISSSy „ 4Ntl�lllllnyt
<br />�(�J,tuiui�ttlilV�Siyiiyitff5iia rt
<br />STATE OF NEBRASKA )
<br />IttYirlrr yyVV IYI @ 4 ttt ,W
<br />tguW <.lflltltffli .. u,At as <MStIIIilTfttlsra.. _„ irlrt�prttt, 5f�ygiilllltil�i�a)t`
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF STATE OF NEBRASKA, IT CERTIFIES THE DOCUMENT BELOW TO
<br />BEA 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 />BATE OP ISSUANCE'
<br />8/4/2026
<br />LINCOLN, Ij1EBRASKA
<br />\ 202605253
<br />z &a4
<br />SARAH BOHNENKAMP?
<br />ASSISTANT STATE REGISTRAR
<br />DEPARTMENT OF HEALTH
<br />AND HUMANSSERVICES
<br />STATE OF NEBRASKA - DEPARTMENT OF HEALTH AND HUMAN SERVICES
<br />CERTIFICATE OF DEATH i
<br />1, DEOEDENT'S.NAME (First, Middle, Last, suffix)
<br />Brandon Shand Connick
<br />4. CITY AND STATE OR TERRITORY, OR FOREIGN COUNTRY OF BIRTH
<br />/
<br />Aurora, Nebraska
<br />7. SOCIAL SECURITY NUMBER
<br />507-17-8580
<br />5a. AGE - Last Birthday
<br />(Yrs.)
<br />8b. FACIUTY-NAME (If not Institution, give street and number)
<br />Hwy 281 Mile Marker 127
<br />tic CITY OR TOWN OF DEATH (Include Zip Code)
<br />Greeley 68842
<br />48
<br />5b. UNDER 1 YEAR
<br />2. SEX
<br />Male
<br />5c. UNDER 1 DAY
<br />MOS.
<br />DAYS
<br />6a. PLACE OF DEATH
<br />HOSPITAL ❑ Inpatient
<br />❑ ER/Outpatient
<br />/
<br />HOURS
<br />MINS.
<br />3. DATE OF DEATH.(Mo.,
<br />Found July 28, 2026
<br />6. DATE OF BIRTH (Mo., Day, Yr.)
<br />October 24,1
<br />977
<br />OTHER ❑ Nursing Home/LTC ❑ #fospice Faeiltty
<br />❑ Decedent's Home
<br />❑ DOA ® Other (SPeelfT)HIghway
<br />8d. COUNTY OF DEATH
<br />Greeley
<br />9a. RESIDENCE -STATE
<br />Nabtaska
<br />11d. STrtEET AND WOOER
<br />2503 Riverview Dr. •
<br />';.
<br />9b. COUNTY
<br />Hall
<br />10a. MARITAL STATUS ATTIME OF DEATH ® Married ❑ Never Married
<br />❑ Married, but separated ❑ Widowed ❑ Divorced 0 Unknown
<br />11. FATHER'S -NAME (First,:: Middle, Last, Suffix)
<br />Terry Martin Connick
<br />13. EVER IN U.S. ARMED FORCES?
<br />(Yes, No, or Unk.) No
<br />15. METHOOOFOtSPOSITION
<br />❑ Burlaf © Donation
<br />Crenatlon t:.J Entombment
<br />❑ Removal ❑ Other (Specify)
<br />9c. CITY OR TOWN
<br />Grand Island
<br />ie. APT. NO.
<br />9f. ZIP CODE
<br />68801
<br />Plc
<br />9g. NBIOE CrrY urea
<br />YES ❑.NO
<br />10b. NAME OF SPOUSE (First, Middle, Last, Suffix) if wife, give maiden name
<br />Stephanie Schaeffer
<br />12. MOTHER'S -NAME (First, Middle, Malden Surname)
<br />Karen Kaps
<br />14a. INFORMANT -NAME
<br />Stephanie Connick
<br />16a. FUNERAL DIRECTOR SIGNATURE
<br />Patricia R. Curran
<br />16b. LICENSE NO.
<br />1092
<br />16d. CEMETERY, CREMATORY OR OTHER LOCATION CITY I TOWN
<br />Grand Island City Cemetery Grand Island
<br />171FUNERAL HOME NAME AND MA UNG ADDRESS (Street, City or Town, State)
<br />Curran Funeral Chapel, 3005 S. Locust St.,Grand Island, Nebraska
<br />CAUSE OF DEATH (See instructions and examples)
<br />le. PART I. Enter the chain of events- disuses, Injuries, or complications -that directly caused the death. DO NOT enter temrinal events such as cardiac arrest,
<br />respire 'matt, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one pule on line. Add additional lines If necessary.
<br />IMMEDIATE CAUSE:
<br />l aa+EDlaTsamisarin t a) acute respiratory arrest
<br />disease, Or rwMkRin resulting
<br />In death)
<br />Sequendaky get conditions,*
<br />MG. weft* the Caine listed'
<br />on own.
<br />14b. RELATIONSHIP TO DECEDENT
<br />Spouse
<br />16c. DATE (Mo , bay, Yr.)
<br />July 29, 2026
<br />STATE
<br />Nebraska
<br />17b, Zip Code::.;,:
<br />68801
<br />APPROXIMATE INTERVAL
<br />onset to &glut!
<br />Minutes
<br />DUE TO, OR AS A CONSEQUENCE OF:
<br />b)gunshot to the head
<br />DUE TO, OR AS A CONSEQUENCE OF:
<br />Enter the UNDERLYING CAUSE C)
<br />Wawa* or Injury that initiated
<br />the events resulting in death)
<br />AAST
<br />DUE TO, OR AS A CONSEQUENCE OF:
<br />d) N
<br />18. PART a. OTHER SIGNIRCANT CONDITIONS-Condltlons contributing to the death but not resuitingin the underlying cause given I
<br />none
<br />IF FEMALE:
<br />❑ N*E pr.i nant wlihln pact yltr
<br />❑ Pnyrutd at tans of death
<br />❑ Not pregnant, but pregnant within 42 days of death
<br />❑ Not pregnant, but pregnant 43 days tot year before death
<br />© unknown k pr4gMntwtthin tke past year
<br />22a. DATE OF INJURY (Mo., Day Yr.)
<br />Unknown
<br />21a. MANNER OF DEATH
<br />❑ Natural ❑ Homicide
<br />0 Accident ' ❑ Pending Investigation
<br />® Suicide ❑ Could not tie determined
<br />22b. TIME OF INJURY
<br />Unknown
<br />n PART I.
<br />21b. IF TRANSPORTATION INJURY
<br />❑ Driver/Operator
<br />0 Passenger
<br />❑ Pedestrian
<br />0 Other (specify)
<br />onset to death
<br />Minutes ;;;,
<br />onset -to d 01
<br />19. WAS MEDICAL EXAMINER'
<br />OR CORONER CONTACTED?
<br />® YES ;.:,f] NO.,
<br />21c. WAS AN AUTOPSY PERFORMED?
<br />❑YES ®NO
<br />21d WERE AUTOPSY FINDINGS AVAILABLE
<br />TO COMPLETE CAUSE OF DEATH.
<br />❑YES ❑Ng;
<br />22c. PLACE OF INJURY -At home, farm, street, factory, office building, construction site, etc. (fy)
<br />Highway
<br />22d. INJURY AT WORK?
<br />❑YES ®r4o
<br />22e. DESCRIBE HOW INJURY OCCURRED
<br />Self inflicted gunshot to the head/ rifle
<br />Fi
<br />5
<br />22f. LOCATION OF "INJURY -STREET & NUMBER, APT.NO. CITY/TOWN
<br />Hiohwav 281 At Approximately Milepost 127. Greeley
<br />a
<br />g
<br />23a. DATE OF DEATH (Mo., Day, Yr.)
<br />23b. DATESIGNED.(Mo., Day, Yr.)
<br />23c. TIME OF DEATH
<br />25 DID;:;
<br />© YE
<br />23d. To the.tpt or mY trrbwledge, death occurred at the time, data and place
<br />and due to the aauea(a) stated. (Signature and TM1a)
<br />r°SACCO;USECONTRIBUTE TO THE DEATH?
<br />S NO ❑PftOBA
<br />27. NAME ;) ANDDRESS OF C
<br />j
<br />Joseph F. M ally, Greele
<br />28a. REGISTRAR'S.SIGNATURE
<br />BLY ❑ UNKNOWN
<br />28a. HAS ORGAN OR
<br />❑ YES
<br />STATE
<br />Nebraska
<br />24e. DATE SIGNED (Mo., Day, Yr.)
<br />July 29, 2026
<br />24c. PRONOUNCED DEAD (Mo., Day, Yr.)
<br />Julv 28.2026
<br />68842
<br />24b. TIME OF DEATH
<br />Unknown
<br />24d. TIME PRONOUNCEDGEAII
<br />03:02 AM •
<br />24e, On the basis of examination and/or investigation, In my *pinky deathotcartsd R
<br />the time, date and place and due to the causes) stated. (Signature and TNN)
<br />Joseph F. McNally, Greeley County Attorney
<br />TISSUE DONATION BEEN CONSIDERED?
<br />P7 r
<br />ERTIFIER (Type or Print
<br />County Attorney, 101 S Kildare ,kGree : - + ska 68842
<br />!!--4A Be n
<br />26b. WAS CONSENT GRANTED:
<br />Not Applicable if 28a is NO 07$. ❑ NO
<br />28b. DATE FILED BY REGISTRAR (Mo DMJ, Yr)
<br />August 3, 2026
<br />
|