|
4l
<br />IS,
<br />1
<br />rlD
<br />In
<br />Fema32 9-5-9 9
<br />M
<br />c
<br />n
<br />x
<br />m
<br />n
<br />n
<br />u'"
<br />o'
<br />N
<br />_
<br />C? Ell
<br />O —1
<br />En
<br />Cl,
<br />O
<br />N
<br />CD
<br />rIM
<br />�-
<br />IP
<br />N
<br />x
<br />-
<br />❑ EP... ❑ FFFAHAA
<br />®Vest of Wood Riv
<br />e•Pi rtv Name Imm�xwumn PwsxwlFmmnwy
<br />w -
<br />3 mi west of Wood River on Hwy 30
<br />❑ �n •' ° °� ^-
<br />.,..T„wNOP H�M� mHall ,
<br />Wood River ❑
<br />IM 1.F CTV..15
<br />CITY TERNNORLOCATO, b STPEETANONVMBER IncquMZmfab iW
<br />AS FEE ' BE'D.I STATE EE COUNTY
<br />River 1305 Walnut Street - n U° ❑
<br />L
<br />Nehlaska Hdllxcarnrw,
<br />WHENT cOPYCARRESTERAISED SEAL OF TIENEBRASKA HEALTHAND HUMANSERVICES
<br />SYSTEr47T CERTrES7HE BELOW TO SEA TRLAE COFYOF THE ORIGINAL RECORD ONFILE WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVCES SYSTEM, VRAL S7AnSTCS SECHOA4WISCH IS
<br />THE LEGAL OEFOSRORYFOR VITAL RECORDS.
<br />DATE OF ISSUANCE
<br />uNDOS�.nE N 11 19899 200200948 HEALTHAANUR &MO S OCES M \ S
<br />STATE OF VASxA OEPA0.ITffNT OF F@ nl ANO FNMA SESEWC_ES FPUNCE A SUFFOki
<br />VRAL STATISTICS
<br />TREY ATJ
<br />NAVE
<br />`w ••e E
<br />� � —vml
<br />Carmen Dolores erer
<br />en
<br />Fema32 9-5-9 9
<br />ro' RRHAA,
<br />osrATEOFBXN x .usA..,m:T�- "
<br />T" 0
<br />HE
<br />u'"
<br />Sioux City, Iaaa 61 _
<br />�5L BELIgv xuuF
<br />PLACE OF BE,rx
<br />MB.a X,me
<br />. M mxEg40 . ❑ x
<br />979 -8603
<br />-
<br />❑ EP... ❑ FFFAHAA
<br />®Vest of Wood Riv
<br />e•Pi rtv Name Imm�xwumn PwsxwlFmmnwy
<br />w -
<br />3 mi west of Wood River on Hwy 30
<br />❑ �n •' ° °� ^-
<br />.,..T„wNOP H�M� mHall ,
<br />Wood River ❑
<br />IM 1.F CTV..15
<br />CITY TERNNORLOCATO, b STPEETANONVMBER IncquMZmfab iW
<br />AS FEE ' BE'D.I STATE EE COUNTY
<br />River 1305 Walnut Street - n U° ❑
<br />L
<br />Nehlaska Hdllxcarnrw,
<br />xx�m M.•�Waod
<br />D
<br />ACE I, Bixu xmA2en Eq,n - A`—nn ETjw IWIOONEO X.1uEGF 9gW5E 1— gvmntvnmm,l
<br />LA LJ B
<br />FTT wiC I1eun Darrel Schwaderer O,UT En lish
<br />Iw raw. w.a. e.wz,.vmgn ..F.J.41SSwOMSTar UE. Isw�ngm E.wn ww FEm✓mw1
<br />VSU•EaLCUe FF �•E ,/b seraew iB.i El LeiMpe n. rvE.,
<br />BE�12
<br />IoIok
<br />q,.ew.xwn.F1 Restaurant
<br />FKE I MDD i LE M ST T OrXEP FusT WOaE Mn CAR SVPxAME
<br />XFa.INME
<br />Garnet A. Phillips
<br />Howard R. Mills
<br />�A'.IE0 VEAw� goes,
<br />Eee.w
<br />ToPM.1M.x, "I
<br />ti I A, ATI
<br />-D= d
<br />119, wOq�AVOE5E fETReTOPPFD NV. Ortv Oa STATE not
<br />P Box 37 1305 Walnut Street wood River NE 68883 _ o
<br />LEXSE NO (�O4 uuE'Mnp =PEFObrpN EOATf CLF N4
<br />E❑
<br />AIR
<br />/ B, a, ❑ "'"° „, SE=pu 7, NF. Crem Services
<br />LP1999 « TCentralL
<br />' w E ro �„ x. oa TONnr TArE
<br />* a
<br />N qAL
<br />Ea f E r, Gibbon, NE
<br />L,.M� -
<br />Apfe1 Funeral Home _`°'"°'
<br />Oa
<br />rm FXxEBWesE SOO ISTPFEr OX w[BrvO [vry TOxu STATE LqI
<br />68883
<br />411 West 11th Street Wood River, NE
<br />11
<br />- Y., e
<br />- ,ENTEaax,DSE nB MNEFbq,n �n. AUD 1[
<br />ED�Are uuBE v�
<br />Mmultiple
<br />m i n p t e s
<br />CCaum3
<br />mxn ADDPEEEOF CEPgM RY"H;Sx cewXEPx gXS�cMNaaOwNn.noPxE. n,,,.non.0
<br />ME •Ellen PO Fox 367, Grand Island NC_
<br />- DNETO. OF AS A OOiA1mMSUGF61
<br />0
<br />s
<br />T 1CACA in ,c lum,'FAR enw
<br />WLE.wA9 TxfnEX” 0 s p� EVG•L
<br />A + EoAET TUO
<br />HAS
<br />.w x . r
<br />-o,
<br />—❑ �9
<br />"accident
<br />/5 /99. 2 3'0" P m automobile
<br />—AT.. NO. .gArt
<br />❑ a. [daV"cE.° s ,MFA.v
<br />,lF
<br />a
<br />❑ _• -A FU. ❑ ® highway
<br />Ili hEg 30 Woad Rivcr NC
<br />-
<br />NB MF OeF MFOFDFA
<br />E, DATE SCE I "
<br />IT"
<br />MATEOFCEAIX MA IT. 1
<br />9/7/L99 oax 2:30 vM
<br />gg yg
<br />1BF.9/5 o0u0 PTA, NY Y,l
<br />qa0 xcEDDE.D ribN
<br />IM+NaT
<br />T"
<br />F C
<br />1g�:ro
<br />DATE.C.ED
<br />55NNa
<br />9/5/99
<br />3:14 a M
<br />€�
<br />Em..aX °w°ww"�wwE
<br />?g - mvAw..ws.. ar aa.. m.. w,•. <ew0T �,
<br />°• ,m
<br />Hall Co. A t I
<br />..w. w.a.
<br />ECCMPIBVTETO M n.s.AX OPn x•
<br />wD,I s� TnED oEYW ©
<br />E <MEiDEPED+ wA4 WN X iED ❑ N
<br />"AT x
<br />I DxXNCXN
<br />A.
<br />I D
<br />mxn ADDPEEEOF CEPgM RY"H;Sx cewXEPx gXS�cMNaaOwNn.noPxE. n,,,.non.0
<br />ME •Ellen PO Fox 367, Grand Island NC_
<br />L. TOCZke, Ilall CounCy Attorney,
<br />TZE GATE FILEOBV PECfimw IMF -CAV Y11
<br />PEGisi NP
<br />SEP 101999
<br />y
<br />
|