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WHEN INS COPYCARRIESTHE RAISED SEAL OF THE NEBRASKA HEALTHAND HUMAN SERVICES
<br />SYSTEM?CERrIHESTHE BELOW TO BE A rRUECOPY OF THE ORIGINAL. RECORD ON FILE WITH kp'
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATXTI6iS'SEO710N, WHICH IS 61
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.
<br />Q
<br />DATE OF ISSUANCE -
<br />J U N 2 0 2003 2 0 0 3 0 8 3 2 6 ASS1$TANr's G1SSTRAR
<br />LINCOLN, NEBRASKA HEAL TH AND HUMAN SRRVIGESSYSTEM
<br />Ip STATE OF NEBRASKA - DEPAR'IMBNT OF HEALTH AND HUMAN SERV1:M FINANCE AND SUPPORT
<br />VITAL STA�
<br />CERTIFICATE OF DEATH 99 00778
<br />Dale Francis Muhlbach Ma4aule - Im 2 1999
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<br />WHEN INS COPYCARRIESTHE RAISED SEAL OF THE NEBRASKA HEALTHAND HUMAN SERVICES
<br />SYSTEM?CERrIHESTHE BELOW TO BE A rRUECOPY OF THE ORIGINAL. RECORD ON FILE WITH kp'
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATXTI6iS'SEO710N, WHICH IS 61
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.
<br />Q
<br />DATE OF ISSUANCE -
<br />J U N 2 0 2003 2 0 0 3 0 8 3 2 6 ASS1$TANr's G1SSTRAR
<br />LINCOLN, NEBRASKA HEAL TH AND HUMAN SRRVIGESSYSTEM
<br />Ip STATE OF NEBRASKA - DEPAR'IMBNT OF HEALTH AND HUMAN SERV1:M FINANCE AND SUPPORT
<br />VITAL STA�
<br />CERTIFICATE OF DEATH 99 00778
<br />Dale Francis Muhlbach Ma4aule - Im 2 1999
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