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WHEN THIS COPYCARRESTHERAISED SEAL OF THE NEBRASKA HEALTHAND HUMAN SERVICES
<br />SYSTEK ITCERTA ES TIE BELOW TO BE A TRUE COPYOF THE ORIGINAL RECORD ON FILE WITH
<br />THE NEBRASKA HEALTH AM HUMAN SERVICES SYSTEM, VITAL STA77ST/CS SECTION, WIICN IS
<br />THE LEGAL DEPOS ITORYFOR VITAL RECORDS, ���
<br />DATE OF ISSUANCE
<br />q 2 ff i1 H 1 4 H Imo° 0 ANLEY S: COOPER
<br />AUG 16 2000 FIT II S Y V vl1 ASSISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA HEALTHAND HUMAN SERVICES SYSTEM
<br />STATEOFNEBRASKA -DE AkTMFNTOFFBALTNAND11 (IMANSERWCESFINANCLANDSUP RT
<br />VITAL STATISTICS
<br />CERTIFICATE OF DEATH
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