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<br />NOSTER CiYPNO S,xiEOLB Pix NNnuSa vmme vi B' M u OP S wAr. oah 1m11
<br />80 November 20, 1921
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<br />Recorder's Memo:
<br />Lot 5, Block
<br />2,
<br />Brentwood
<br />Subdivision,
<br />City of
<br />Grand Tsl.and,
<br />Hall County,
<br />Nebraska
<br />WHEN THIS COPYCARRES THE RAISED SEAL OF THE NEBRASKA HEALTHANU HUMAN SERVICES
<br />SYSTEK RCERTIFES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD ON FILE WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTICS SECTION, WHICH IS
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.
<br />DATE OF ISSUANCE 2 0 0 2 0 0 9 0 0 I OAS S COOFEk.
<br />JAN 8 2002 J(7 J ASSISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM
<br />STATE OF E,,I DOS"17 POT OF NF. V. TN AND ADMAN SMW73 FINANCE AM15DQpIT 14771
<br />VTD L STAT6TCS - (V' 1
<br />CFRTIFICATE OF DEATH
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<br />December 23, 2001 _
<br />_Wrenn
<br />NOSTER CiYPNO S,xiEOLB Pix NNnuSa vmme vi B' M u OP S wAr. oah 1m11
<br />80 November 20, 1921
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