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<br />WHEN TM COPY CARRES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERV ICES
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<br />THE NEBRASKA PEAL TH AND HUMAN SERVICES SYSTEM, VITAL STATISiN:i$EFnOQ`Y7MCHJS
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. �1
<br />DATEOFISSUANCE
<br />DEC 10 2002 (It21.�aaPE,€ .
<br />ASSMTANTSTATE TRAR- °
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