|
30 CO KS BK:202607
<br />20260727-0008293
<br />Pages: 2 F $38.00
<br />Register of Deeds
<br />7/27/2026
<br />. :
<br />9:18 AM
<br />120260038275
<br />altmentoffiealth and Environment
<br />Office of Vital Statistics 0 7 2
<br />CEItTIFICUTII:)CDEATIHE
<br />State Mk NuMbert 115*2026-070$5
<br />deut.si.;egittNallie (8trit, Midtile, List): Last Name Ptior to rst 111aniage:
<br />Datel*Ce of Deatitt, -, ,Age; : . ,Date uf.R1,_ Birth Sea: , Social Security Number:
<br />'\ • ' , ,.
<br />0312812026 79 YEWS) t)212311941 MAL 506-58-8855
<br />, -
<br />*St*.cfAtitiretis:::-:••••.... ..,....::::.,:,. .•:,•..CitYar•Town' • • . • :••,••••••:: .Stateati.elreig9
<br />ut ••• ittry• '•••-•s
<br />• •-• • , ' •
<br />1622,i,4r.S.g.W b1),'”.,;., ..-. , ..• :.:••--•:.:-:.*•:','; •,!:-.'-.1.'-.•• ::00..,.,.ND'ISI,A:N• • • ''•D . ::•,.. ,.:::::.: .::::.:1.•....N1,34AAS• ...4... '••::,.•:;.. •:.-•••• • .•.;•:44'.:- •4"' -•..-.:::11.-.:.'..':.•74ii 8c5..5...°....14.
<br />•:aritifNee koft3Bith• .'. •..:..-,.A...'iot Forces m.aritiiis.t. iiis..:.'.'''-•Su-. iingSpouse (N•'i•-•ri-•e•.i'iio. r'fo"-rii'i'V. at••••••••i'
<br />ge)
<br />aRAsKi,YES mARRapS. .
<br />.e.,..- -:::. -SANDRABISHOk • ••••••'•• •••••"' • •••'• ' ' ' " • • ••• •
<br />-E......:,.... ,•.•!4.atittell'ilteOt NOsket.R.01049•Ffritst IVIIIiirlip: ,'..-..'.: - MothatiParent•Nameftio.rto..firs- t.karsikge— : • ' .,-.:' --.. '
<br />,.:::„....:..... .401-1N,qopqN owN..:,:::::.,.:: .:,::.....-.;::::-.. --..-.::.
<br />..,,,,...,.. ..,....-,..-...-- ...... :CAR...01.EMA UD.E.... Isil901tE.:,...;"•,.:.•:..-:::: •.:•,.:;,:.,"::•-•:::::•,..:;:,:::::::::. „:.....;.;.::: :„, , :::.:.:.-.:-...... :
<br />'' '" • ':-''';'':s'•.-'''''•.''.:.'''''':.'''':..:•.''''.'-. .:..' .'' ' '"''''.•''.- '•' ' ;' •.1.'i..•.:SiN. m.•tace
<br />T....:...I.;E•Ft.,TN..,..s'..-,,.-.•.•..,.: .•.w:.-..,'.-,.,.,..:, ,...,,.:,..i..„., .-,i_.-•„P,'::,."
<br />. .,..-,•:-:..i.,..„•.:7,....-;.. :..',...,.-•,...,`,.,,.:,,•:..
<br />-„,•',,' ,''. .,
<br />ERRIAM
<br />..••-,•.'''::,:::,'.,•.'' .. 1a• ,c.1..- 1tY..N.fa1! ADVENIBBAL11.ESr.
<br />HE.RA0..W •NFE O..••_S:..I.:.ON.:.,-91...,90..::W ..14....14;.3t
<br />74.Ir:viof,Death.County oDeath?4Pc.l..: id
<br />;OWSON6204
<br />$4)d°1•11JP946:14* 01018P9iti0144110, 4.
<br />e..N„...- 0....,i.tt............p.. .......?.-'.•.
<br />t..,S..,
<br />p.:.....,0...„..,1, 41• 0•••.• 1
<br />OYAL1Qmgf.ltiERSIDE C0vY PV01atASX
<br />.ednte°:Pal;n
<br />4O
<br />Decedent'sw"0p,.. ..,.:..-.,•...-....:...r...•.....:...'..:".•.•., ,:..... . , ,..,..:::,:-.,... .:.:.......-:. ,::'-..:....,.:-,:...::::....::..•:..•..•,.... ..,:-.,..,.,.•:.',„;,...'.."....: .
<br />Rig
<br />hifonnina's Nae
<br />oar
<br />ml.
<br />Nioit and Addre.inif Thm
<br />ptNftixv4.f.Ex
<br />• o ..itAJniN114.4 : .
<br />:taure of beath:
<br />•
<br />- •
<br />• :
<br />Other S :Mt: on
<br />• %lige:44
<br />•-"Place Ofbijutyt
<br />Medical Certifier
<br />RAINING LIAN
<br />Approximate:IntetrtlitOntet to t)eatti::::::
<br />• , •i .•..
<br />•• • • :•••••• • • • •
<br />If Female:
<br />nate certified:
<br />Date.R.iledAyState Registrar:
<br />"OM It'2026..:.
<br />, 4/2026
<br />•
<br />04/02/2026 F021841134901 OLSON 202604007015 5 121tOMbR-:'
<br />
|