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<br />WHEN THIS COPYCARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN4ERWCES
<br />SYSTEM IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECQF&.DA/LEWITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATIS� W N 11S
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. v = //'� \�
<br />DATE OF ISSUANCE `^; 0
<br />JUN 2 6 2000 4'1 AAtEY.E &Pffi
<br />ASSISTANTSIATF, IRA!£
<br />LINCOLN, NEBRASKA HEALTH AND HUMAN SIGBFEIq
<br />200202550 =
<br />STATE OF NEBRASKA - DEPARTMENT OF HEALTH ^
<br />BUREAU OF VITAL STATISTICS 9 1 J (0 4 D
<br />CEfMP..CATE OF DEATH --
<br />-.----- — - .__. T - - --- ...
<br />I OfCf OfNi NANf ,IP51 NIDDL! LAS! T1 YIY
<br />John Paul Sullivan Male December 30. 19gn
<br />-
<br />I, Oil NO STATE OF btw YMIn YSA. A6 RI �Y .— 7.; - ...-_.
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<br />Hastings, Nebraska 1 68 July 17,
<br />- _ 1922
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<br />404 W. Cedar St. Doniphan YP Hall
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<br />Nebraska Hall Doniphan 404 W. Cedar St. 68832L yt,4
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<br />to RACE y[. Ye Y.. wcY. Aww<AII wPl1 I I ANL[Brgr 1. wn. w a✓I w. .0 l �.. _•• —. ; - -
<br />[ I] MANWFD Nf VER YAMPoEO NAYf JI YRl1UL( II V4 p.. n.,.
<br />M[IISIRM) 19p[hl Al UVO "`IEprch
<br />White American Married_ Milrae Levin
<br />IA. UyJgL OCCWATpN (OIW EMWwR. Wn. M+p noN E RI NO OE SUyNE551NW5TRY -' - --
<br />a.wyrt.Nn.n.Nar 'I,J GI \E EMm✓un S.con+✓Y ID yI CPNY L•I
<br />Farming Agriculture 12th Grade
<br />IE FATNGR. NAile IcASI YrLULe usr .I' WINER. ..RAIN NAY[ -;if IROOIE - iisi..
<br />..Eugene NMN Sullivan _ Iva NMN_ _ Kin Stun_
<br />iI WAS CECEESED
<br />W U B HEWED EDII(:FBr
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<br />19 .NIOAM.NI- NAME � NA11W ADORESS ❑IAEE I OR R I� CI1V ORtpWN. SIAt(, JP
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<br />Milrae Su111van,404 W. Cedar Sty Doniphan. Ne..
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<br />XO. MT[ e0[LEYEiERY ORCMMAI(WV �NAYE ]M IOC I" C1f1ORIOW.I YIAip
<br />Burial
<br />an. 3 1991 Cedar View Cemetery Doniphan, Nebraska_
<br />Fl.f TYRE fNS[NO In .VINFRAI WMf MAYE AND bp1E$/ WREST ON R EU NO CITY OR TOWN SIAI El 168bOl
<br />I.ivin ston- Sondermann 505 W. Koenig, Grand Island Ne.
<br />RYI[ IENTERn Y E1ME CAUSE PER LINE FOR 10). RR. AND lei) NNnr e.lN.r, Y,,.l.IIP NA
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<br />D11E TO. ON A9 A CONSEQUENCE OF INNVII A, p wn vyY Yq E..b
<br />DTNFA BIDYFI T CON(X g S. ORRNN,.. -AAAA tldM W e.INp PART N IF FCW. E WAS TRERE A N A10,3Y }S WAS CASE REFERRED 10 YEpCAt
<br />PREON.WCY IN Mf ARSE 5 MONTN', (Sycl, YPF a Hol EMAYNIEq OR LpgNER+
<br />,.o NP O ,y /Vo rSPKA, Yw
<br />TV ACCTDExT. 91I NDEiCgCtINOEi. 3A DATE a RFAIRY SaR.Wr rrl
<br />EEIE ROURa WNPY
<br />EN. OEBLN/E NONI WIURY OCLURREO
<br />OREKNDWO/NHTEUIIOEe !Sl'.CMI
<br />N. NMIY - Rpy
<br />NI PLACE CE RYURY . N IMAV. I✓m. q.N 1K1YY.
<br />ME LOLATiON ETREEI CR R F D W CITY O ......T
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<br />V. DATE CE MAIN RN.Oq, Y, .I
<br />]RA WE bONED ryP, oft Yr(
<br />1Fp TON! OF DEATH
<br />x December 30, 1990
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<br />Mc PIEDNOVNLEQ OFAD (fb. by WI
<br />FM. PPONgINCED OCAp (Np.)
<br />',,January
<br />Inc
<br />2, 1991
<br />4:15 P.M.�E
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<br />1M DID TOEACCU Y3E MA"
<br />ORGAN OR TI56UE LONATgN [TEEN Cp1S10EREDi � WAS CCNSENi GRANTED,
<br />0 YES ❑ Uq(N[MN
<br />O YES I„
<br />IT l% YES
<br />T
<br />]l. NAYS RNO � OF CEgTIFER (PMYBILAN. COEM)NfR'8 PNYSICAN OR CWNTY ATTORNfYI [TYpW RI,d --
<br />John A. Wagoner, Jr. M.D. 800 Alpha, Grand Island, Nebr. 68803
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<br />]Fx ,EQI$TgM
<br />B1S WTE REGI om, Yrl
<br />JAN 7 1991
<br />Lot Two (2), Block Three (3), in Gideon's Addition to Doniphan,
<br />Hall County, Nebraska.
<br />
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