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WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERVICES <br />SYSTEIW, IT CERTIFES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD ON FILE WITH <br />THE NEBRASKA HEALTH ANO HUMAN SERVICES SYSTEM, VITAL STATISTICS SECTION, WHICH IS <br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. <br />DAj,F'( ISSU/1/I(CSF�o l/ ANLLW_S.COOPER -. <br />��JJ ���� ll}} ((uuuu AswsPANr STArb REGISTRAR <br />LINCOLN, NEBRASKA HEALTHAND HUMAN SERVICES SYSTEM - <br />2 � OSA�.I AkTAff T OF HFALTH AND HnMAN SERYCFSFMANET AND S(11 )Kr <br />V JJ o �G MAL STAUSTIC5 <br />CFRTIFICATH OF DEATH - <br />us S <br />Srx _.. .,T. <br />Maynard Ernest Schimmer M <br />Male November 27, 2000 <br />rs ,,,.,.., .a„ _ <br />_ E <br />E„A .N,N ....1 _. <br />Rural hall County, Nebraska R4 N <br />November 14 1916 <br />5 <br />506-12-9815 A,M,.N N „_ ,....�.. N°SA THE ❑ �, o . A © <br />I o ,N, M ,. <br />❑ E ❑ AE <br />Hamilton Manor ❑ IDA ANN — <br />i <br />IIwN Ow11U.NON �1 ou, 11 '- i <br />i " <br />> >AS <br />w❑.. ❑I' ❑N ❑ .o� INININD <br />1151 J ... T" IN 11 Ill .. <br />F L a. y A AE m.ED M— , ExA oN STAEEIN AAONO _- ANTOwN STAI <br />��� �- ESE- I,,0 ❑� 1ATIAIDDI AN, m,.. 111, T,.E °FICA,. — <br />uianloo <br />AITITDEeNE - o.w . - ECIAIAIN - EAI IA, <br />1. kale Ii ��CiO C� 04 oo �.,M . <br />'f I q. a..N x. <br />I o a ..N 'ii <br />F F jL✓ I A �TT F <br />138 OACCC VSF CON B IT T AT p0. CAN OnJ SWE BEE ON9V GNAWED <br />— A A 'D ❑ ❑ ,❑ � n �N w - o ❑ M rv. <br />i wuuE'i�!2. _ <br />J utii E, f :�Oe L 1 �, <br />T DATE NEW �1�A <br />T s.AaA 13 1�. '4� 1 P 2000 <br />