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<br />I DATE OC DEArN MAEAOx. 1w1
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<br />December 10, 2002
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<br />peril 17, 1925
<br />a SEEN DFDUFrn NUMXCP
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<br />505 -48 -9886
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<br />845 W. Gnenther Rd.
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<br />11 NAME OF BPOUCE In. M IIII HATIN
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<br />Marcella Parkos
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<br />Livin ston- Sondermann F.H. ❑°N— ❑'FAF Grand Island, Nebraska
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<br />WHEN THIS COPYGRRES THE RAISED SEAL OF THE NEBRASKA HEALTH AN
<br />SYSTEM, RCERTMWS TIE BELOW TO BE ATRUE COPY OF THE ORIGINALAE
<br />THE NEBRASKA HEAL IN AND HUMAN SERVICES SYSTEM, VITAL STATISTIC:
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.'
<br />DATE OF ISSUANCE mww
<br />DEC 26 zoo2 200214667 ASSISTAMTSTATE
<br />LDICOLN, NEBRASKA HEALTHAACHUAMN$E_RM
<br />STATE OF NEBRASKA- DEPAILTIM Nl' OF MW.TH ANO HIIMANEfi1FWEfiSfP1A
<br />YRAL STATISTICS - ---
<br />CERTIFICATE OF DEATH
<br />WITH
<br />02 14755
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<br />I ALI
<br />I DATE OC DEArN MAEAOx. 1w1
<br />Maynard Sohn_ Stelk
<br />Male
<br />December 10, 2002
<br />uNDEN1Dav
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<br />x. xou3s Mws
<br />Hall County, Nebraska 77
<br />peril 17, 1925
<br />a SEEN DFDUFrn NUMXCP
<br />I PLAGE GE DEATH
<br />505 -48 -9886
<br />GAREAL X❑ �LFAMF ❑ 1FAM lbmf
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<br />11AEEi AxINUUeEP IM.nw,vzm x'6'803
<br />-NT
<br />Nebraska Hall Grand Island
<br />845 W. Gnenther Rd.
<br />1s ❑ �®
<br />E.IeB.w BMl Ama FARAIIn
<br />MWhite
<br />ANGFSr vlxD navel, Me.ax„GN�NMI. MN
<br />a ®MNINT1 ❑1-11
<br />11 NAME OF BPOUCE In. M IIII HATIN
<br />Nn MSre.'NI
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<br />M AVOIDED
<br />Marcella Parkos
<br />e.u OODII —EA INIAL AOINES:m1.m,,,NHANI
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<br />Barney Stalk Ella Schimmer
<br />B NAB DECEA SED EVEN IN LL
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<br />3845 W. Guenther Rd., Grand Island, Nebraska 68803
<br />AE LMEP -Si tUPE OEHSE NO. w. MET1gp OF 0i5PoBUq HE BPIE ]IC CEUEIEPVOPCPEMATERY NAME
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<br />❑PI Dec. 14 2002 WestlavEn Memorial Park
<br />.v xEUAE t -rvnM[ BIA GEMETEFY OR GA[MAERELOGAREN FILE ON irnm STATE
<br />Livin ston- Sondermann F.H. ❑°N— ❑'FAF Grand Island, Nebraska
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<br />XELIpMEADOPE3s ISiPEEi qI P.FD NO. pry OPiOWM.sKiEEIPI
<br />601 N. Webb Road, Grand Island, Nebraska 68803 -4050
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<br />n. IMMEDIATE GAUD uln.i uewenmmunnnealn
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