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<br />WHEN THIS COPYCARAES THE RAISED SEAL OF THE NEBRASKA HEALTHARD MIF!_�NY' S
<br />SYSTEM D'CERTIFESTHE BELOW TO BE ATRUE COPY OF THE ORIGINAL AE4O�DYRI FFiEWLrN
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM. VITAL STATISTKES lE01716LkAIII -i l
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS. A c= "5__'jJ_ =`_t,
<br />DATEOFISSUANCE Y"E' --4�Y- COOPf3P
<br />JUL 182002 )- 003U,270,5' ASSI4TINT ATEREGISTRAtr_
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<br />STATE OF NEBRASKA- DEFA TWFFF OF f@.U.TH MID Ful $aLMCEiFi M"AAQ_SUOMRT
<br />Vn'AL STATISnCS 0 2 07849
<br />CERTIFICATE OF DEATH
<br />[AS ' sE, -I „! -'IA
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<br />Lot 5, Block 2, Clausen Country View Add to Grand Island. Hall fhii/v rp, 1!iehraeka
<br />WHEN THIS COPYCARAES THE RAISED SEAL OF THE NEBRASKA HEALTHARD MIF!_�NY' S
<br />SYSTEM D'CERTIFESTHE BELOW TO BE ATRUE COPY OF THE ORIGINAL AE4O�DYRI FFiEWLrN
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM. VITAL STATISTKES lE01716LkAIII -i l
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS. A c= "5__'jJ_ =`_t,
<br />DATEOFISSUANCE Y"E' --4�Y- COOPf3P
<br />JUL 182002 )- 003U,270,5' ASSI4TINT ATEREGISTRAtr_
<br />LINCOLN, NEBRASKA HEALTHA S8YSTEMT
<br />STATE OF NEBRASKA- DEFA TWFFF OF f@.U.TH MID Ful $aLMCEiFi M"AAQ_SUOMRT
<br />Vn'AL STATISnCS 0 2 07849
<br />CERTIFICATE OF DEATH
<br />[AS ' sE, -I „! -'IA
<br />Betty Rose
<br />Hawke
<br />Female July 5, 22002 _.
<br />eC— ANDSTATEO/ "Prx m — Own.wwuv.
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<br />�`� ®au,lnl ❑P. July 9, 2002 WestlEl Memorial. Park
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<br />Livingston- SOndermann F.H. ❑C'""`°" ❑°""°' Grand Island, Nebraska
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<br />601 N. Webb Road, Grand Island, Nebraska 68803 -4050
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