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<br />Recorder's Memo: -
<br />Lot Two (2), Calvary Subdivision, City of Grand Island, Hall County,
<br />Nebraska.
<br />WHEN THIS COPY CARS THE RAISED SEAL OF THE NEBRASKA HEALTH AiINCES
<br />SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIOI BEi- TEEWHiI
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STA WtgG113
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS.
<br />DATEOFISSUANCE 200209313
<br />AUG 2 9 2002 A"'s `Tt..
<br />ESISTANTBTAFEIAEBA47RAA /
<br />LINCOLN, NEBRASKA HEALTWAND HUMAN SERVIgUSYSTEAI
<br />STATE OF NEBRASI(A- DEPARThfrNS OF NCALTH AND f1mMAN 360.V1(8F1NY4CShNO511PPo^ /AT 08573
<br />rVOTIFI 0TF F nFATH L 0 `—
<br />[ceotrtr -rvw_ Flnsr MIDDLE KN— �:"- 'EDgrEOf
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<br />�iAGITTAND
<br />Isabelle Alice RllZlcka Female Jul 18 2002
<br />a E N 6
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<br />a
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<br />Elyria Nebraska IE 72a? October 17,_1929
<br />SOCIALUERNIYLI E.. �
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<br />St. Francis Medical Center ER - --
<br />S°. cav NOwNOD LOC.!lox of OEATN _ w o �DV D41r
<br />r.OUNn of Da,TN
<br />Grand Island WI "° ❑ _
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<br />NA RESIDENCE STATE w. cNJNI11 —
<br />EN rm TOWN LOCATION
<br />Ixn.< I DE CIT v LIrNs
<br />m ANDESTAxu NUMN . m�,e. m 68
<br />Nebraska
<br />Grand Island
<br />1410 N. Custer Ave. ❑ N° ❑
<br />I ADD .I, y, Wrt4- .Iaa.Ia4,.
<br />AS, NI E,n.11 o..m.D NC1
<br />11 UMM,.ED Ej ...ED
<br />I I NAME DF., ?DDIE 11mr1
<br />coca l$¢m
<br />White
<br />ISAMSE,
<br />Ameri
<br />LESS. DIVOPCEO
<br />MELEE
<br />F}Di1 A. Ruzicka
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<br />WILORI N ITS- bw�demedm,plma
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<br />WNDOFWAwES.O...mv
<br />WGTON
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<br />IAwnN°"VI91 111 wml
<br />"D°lage'inma�
<br />YWISE 11
<br />11.1E.— IDEEAN,
<br />Home Maker
<br />Own
<br />12t�'i
<br />16. FATHER, NAME FlSIT MIDDLE EAST
<br />MmnLP THREE MIDDLE MAIDEN EURNAME
<br />Ignatius NMI Krason
<br />Frances NMI Koziol
<br />,N s sEO Ex ° - MAN nME en
<br />H, .dEA:
<br />NO N/A Mmil A. Ruzicka
<br />W rv�owMU+T M.IU4r, ACDOES1 IsmEET ORwFD NO c,ry oa row N. sN.NEtIyI
<br />1410 N. Custer Avenue Grand Island Nebraska 6880 ___ _—
<br />MEMO
<br />DRE
<br />NEW
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<br />July 20, 2002
<br />Westlawn`Memorial Park CemE
<br />FUN EINLIMME ���111i''''
<br />ME CunEEwv MGPWATINY I pwTnx Orr WMOWN ENRF
<br />Kleine Funeral Home
<br />❑`"`""'"" ❑°invon
<br />Grand Island. Nebraska
<br />D...o.. .— AL11111 e]uPOICA aF O ro ccbR TOWN
<br />STATE AS
<br />IMMEDIATE , _ Nebraska 68803
<br />3213 W North Front Street, Grand Island, Nebras
<br />U .. . F EDADEEMEMLNEFOP .. m. INS 1111
<br />_._ ✓ u
<br />Natural causes 2 hours
<br />I ill
<br />OUE ID.ORAA ACONEfWENCER nm.r°I pnvm^n'I'M a•.a -
<br />IOIEeNFCAOISUNOTONE OmLUMOO I.EERES11 -WiS4W x �I O Av ORO IOL
<br />AS DMEOFNINPY ,.M SET 14 DDUFOE NNR FLiDNE ]LdPPEB
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<br />17, GATE OF DE I 3B+ BG D MHE EMS _ Jul 23 2002 1:58 am
<br />OE EUTELG ED Mu i£ ¢ 4–LT-
<br />IN , di. . 1,SSo�iA, u.i "Da xn 4aE meaE.. waWeaN ° °. }a11 OOTC9 OUSECONNRIIBBUTETDYILDEANI? xAEOWAN NATOU BEN IE] NO LJ No ❑ UNNNDRA OD ®U v5 ❑ ❑ x0
<br />MENU DDFSSOFCEF7IFIEA IFNYEpIAN, COFONEREPRVACNNOPCWxiv AT]OMNEVI lNVced�^a!
<br />JeromADE Janulewicz, Hall County Atty, 117 E 1st, Grand Island, NE 68801
<br />EAI JULG 2�9 2001
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