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200310345 <br />WHEII THIS COPYCARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SE III <br />SYSTEM, IT CERTIFIES iNE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD DN FILE WITH <br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTICS SECTION, WHICH 13 <br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. <br />DATE OF ISSUANCE 6FANLEYS. COOPER -2 <br />MAY 15 2001 ASSISTANTSTATE REGISTRAR_ <br />HEALTH AND HUMANSERWCES SYSTEM <br />LINCOLN, NEBRASKA <br />STATE OF NFNMSAA- DFFAA1NT OF tff+ AI A KFDDAN Sm'VeFS FP'ANCE AND SUPPo0.T 9 <br />VRAL STA IDUCS 0916 <br />CERTIFICATE OF DEATH <br />O, <br />June Virginia u. y 1, 2001 <br />yinia Novy -Sea Female Februar <br />i. DFFATEOt u3 + +m rnmr,. jF Fwi Oi <br />Hazard, Nebraska <br />N�MaFN <br />N 507-24-5276 <br />A <br />tastmont lowers <br />Tx <br />Lincoln _ <br />- -p AT <br />Nebraska _Lancaster <br />ary 28, 1915 <br />Na El <br />Lancaster <br />uTs <br />p b w�V[ <br />c . <br />cry Towx on <br />xLi <br />68510 <br />❑ <br />E o.1 IN <br />❑ <br />w ,. <br />n oln P <br />DID <br />sFo <br />oow <br />[3a <br />U . <br />Na El <br />Lancaster <br />uTs <br />p b w�V[ <br />c . <br />cry Towx on <br />xLi <br />68510 <br />n ^❑ <br />6315 0 st <br />n oln P <br />DID <br />sFo <br />oow <br />[3a <br />U . <br />Ft <br />_ <br />a. i ua OF N,V a9 u OC Ta u� <br />s <br />� <br />�� <br />A. <br />,el oo OF INS '11- <br />-, �o a� M— A <br />A ❑ ❑ <br />NA I I a rvun D <br />o A Tn <br />- <br />Own Home <br />F .. .,N —F <br />MAIDEN SUANNAEL <br />I ANT <br />Clifton pp, Roberts A Mildred Erazim _ <br />005' <br />Lynn penzler <br />- s�� „A— In„ „INCnooNn s, Nm oa... �c o owN <br />,10,17 South -76th Avenue, Omdhao Nebralska 68124 -o E„Tw.,�A. NAM, - <br />L�x %% Feb. 2� 2001 Sunrise Cemetery <br />.sc aEe,csw, -: /0]�1 ®s •.. ❑ "•�c."' AwFNMT0K -. A71SN `-. 'w NTIIL <br />x.NnF,wmF NA„t CIA I� ❑ N E <br />Wahoo <br />Pr¢SS Funeral Home_ - �--- <br />911 North Linden, Wahoo, Nebo.raska <br />rcil <br />wDDALL��rl-nNSe rew uN— ,•NC <br />FINT � <br />ooeNat't�'�5�.{r�r <br />IS <br />ti -,o FEASaw—IUecwF <br />1, aMSw � <br />_ <br />a. i ua OF N,V a9 u OC Ta u� <br />� <br />�� <br />N Jtxtl <br />A ❑ ❑ <br />NA I I a rvun D <br />o A Tn <br />FA ATN <br />FEBRUAKY 1_2001 _ <br />IF <br />F2/5/01 <br />_ o <br />5 00 Abl-F <br />A.A..... <br />�L �p <br />-- — <br />L�, sssF�FAfp_ -=r— <br />o TES <br />OF- <br />SSAEEEDI A E . perSN N 'A'AITD .. <br />MD ]]0 N CID 'TN <br />I NA <br />H LARRY MITCHELL, <br />ZOOI <br />rov wlc sn�A <br />