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WHEN THIS COPYCARRES THE RAISED SEAL OF THE NEBRASKA HEALTHAR(T AERVICES
<br />SYSTEM, ITCERRFIES THE BELOW TO BEA TRUE COPY OF THE ORIGINAL 49CtRO _ 'NG6IVITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTF.*SfcvbN* T IS
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS
<br />GATE OF ISSUANCE '-
<br />APR 252001 200210964 � I: �
<br />A53/3AKIINi A4TE
<br />LINCOLN, NEBRASKA HEALTH AND HUMAN R!� ,
<br />srAIF OF NEaaASKA DEPARThff•N[OFNEILTHANDIKIINAN $ERVIC'�BNANC6_RtM SIIPgqPoRi
<br />CERTIFICATE OF DEATH 01 04279
<br />M�DD.E LNG
<br />sL. rw,-.,. o200,
<br />DApril
<br />Harold E. Bockbrader
<br />L.o
<br />Male April' 17, 2001
<br />- - _ L. , ?If FAI I venR
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<br />July 18, 1925
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<br />❑ CI_ '' -1
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<br />Grand Island =_ ®” ❑
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<br />RESIDENCE . STATE IOUNFY
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<br />siFEET AND NUMDEF /x:xmirg OR cmq
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<br />Island
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<br />1. RATE S, DUeLATIONIH zn nrvLESTI,., MAY. M...xn- N.AY ®M.RWED
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<br />S2, FU NERN.HOW -NAME
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<br />Livingston Sondemann F.H.
<br />❑"'"°'__ ❑_ °°"' "
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<br />Island Nebraska
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<br />YJerom E Janulewicz.,. Hal Coun Attorney.
<br />Grand
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<br />WHEN THIS COPYCARRES THE RAISED SEAL OF THE NEBRASKA HEALTHAR(T AERVICES
<br />SYSTEM, ITCERRFIES THE BELOW TO BEA TRUE COPY OF THE ORIGINAL 49CtRO _ 'NG6IVITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTF.*SfcvbN* T IS
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS
<br />GATE OF ISSUANCE '-
<br />APR 252001 200210964 � I: �
<br />A53/3AKIINi A4TE
<br />LINCOLN, NEBRASKA HEALTH AND HUMAN R!� ,
<br />srAIF OF NEaaASKA DEPARThff•N[OFNEILTHANDIKIINAN $ERVIC'�BNANC6_RtM SIIPgqPoRi
<br />CERTIFICATE OF DEATH 01 04279
<br />M�DD.E LNG
<br />sL. rw,-.,. o200,
<br />DApril
<br />Harold E. Bockbrader
<br />L.o
<br />Male April' 17, 2001
<br />- - _ L. , ?If FAI I venR
<br />ANO SUre of e.r „�.M,.. os.�µ�., �. -,.., IpA w uo�
<br />ceX DwrN nr w,n COTT 1-1
<br />SL,
<br />HOT',
<br />Hereford, Colorado" 75
<br />July 18, 1925
<br />okra TFITUNTY "IIMDED 11 11AC1 of -AT"
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<br />DNNIxM ❑ R,A�M.
<br />St. Francis Medical Center ❑'"'A
<br />❑ CI_ '' -1
<br />Crtr TOWN Om rcwTiO „OF DEATH iuSiDE LRY LIMiI 'S oWTY OCDEAi.
<br />„ SY
<br />Grand Island =_ ®” ❑
<br />Hall
<br />RESIDENCE . STATE IOUNFY
<br />m
<br />1, TY. TOWN OD r"A"N
<br />aGrand
<br />siFEET AND NUMDEF /x:xmirg OR cmq
<br />MARES Lm Lwlis
<br />Nebraska Hall
<br />Island
<br />3005 N. Webb Road 68803
<br />°R ®w❑
<br />1. RATE S, DUeLATIONIH zn nrvLESTI,., MAY. M...xn- N.AY ®M.RWED
<br />Lj 11 NAME OF SWUSE m me w, m. akn-1
<br />N.111.1m 1sce.�nl He'E"
<br />White American
<br />F Golds Selzer
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<br />�DDA�IDN rsPK,n �.I, AaI.M°m. aTP,IW
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<br />oade
<br />FATN D. NAME MIDDLE LAST "INOR
<br />FEET MMME"SURNAME
<br />Henry Bockbrader Martha
<br />Obermier
<br />WAS DECEASED "" IN USN OWES? I MY Im0"Mn"T rvA
<br />yYes
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<br />� #//4
<br />Apr. 20
<br />2001
<br />West awn Memorial_ _-
<br />S2, FU NERN.HOW -NAME
<br />CEMETERY
<br />_Park
<br />OR CREMOTORVLCCPTO" CITY OR TOWN - STAE
<br />Livingston Sondemann F.H.
<br />❑"'"°'__ ❑_ °°"' "
<br />Grand
<br />Island Nebraska
<br />ONERAL XOME AOOREES IETPEET OR RFD NO. ODV OR TCMN, STATE. SIP1
<br />601 N. Webb Road, Grand Island. Nebraska 68803 -4050 _
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<br />YJerom E Janulewicz.,. Hal Coun Attorney.
<br />Grand
<br />db RE09rNN
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<br />, An um
<br />-APR 2,
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<br />3 2001
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