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WHEN THIS COPYGRPoES TM RAISED SEAL OF THE NEBRASKA HEALTHAND HUMAN SERVICES-
<br />SYSTEM, SYSTEM ITCERTFES TIE BELOW TO WA TRUE COPY OF THE ORIGINAL RECORD OHF"WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STARSTICS SECTA'WI WMCH IS \
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.
<br />GATE OF ISSUANCE
<br />SEP 18 2002 A`f1MX`ZCOOPER
<br />ASMSTANTSTATEREOMTOAR -
<br />LINCOLN, NEBRASKA 200302185
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<br />LEGAL: Lot 2, Imperial
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<br />WHEN THIS COPYGRPoES TM RAISED SEAL OF THE NEBRASKA HEALTHAND HUMAN SERVICES-
<br />SYSTEM, SYSTEM ITCERTFES TIE BELOW TO WA TRUE COPY OF THE ORIGINAL RECORD OHF"WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STARSTICS SECTA'WI WMCH IS \
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.
<br />GATE OF ISSUANCE
<br />SEP 18 2002 A`f1MX`ZCOOPER
<br />ASMSTANTSTATEREOMTOAR -
<br />LINCOLN, NEBRASKA 200302185
<br />NEALTNANO HUMAN SERVICES SYSTEM
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<br />Groner Nilson Bartlett Mabel NMI Nave
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<br />Yes wY 7 19 46-4 17 47 NHII Alice Bartlett
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<br />1310 Sheridan Place Grand Island 68803
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<br />JAN E 9 2002
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