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<br />WHEN THIS COPYCARRJES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERVICES
<br />SYSTEM, IT CERT1FIES THE BELOW TO BE A TRUE COpy OF THE ORIGINAL RECORDDN:'R'=E WITH
<br />THE NEBRASKA HEAL TH AND HUMAN SERVICES SYSTEM, VITAL STA TISTICS.sB:1i6ii;WHIGHoIS
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. ~_-?-c- -{~i)2';.~':'
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<br />DATE OF ISSUANCE ~~~~~
<br />NOV 1 5 2005 200511 719 A SSISt;ANtSTA t,; RtGJSTRAR-
<br />LINCOLN, NEBRASKA HEALTH AND HLfMAN'SERVicES SYSTEj1tr, ,_,
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