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<br />STATE OF NEBRASKA
<br />
<br />WHEN THIS COpy CARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERVICES
<br />SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COpy OF THE ORIGINAL RECORD ON FILE WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL SIAIISTJf:SgCTION, WHICH IS
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. '. =~~.':;-.-.~.-.':=. "'o<--";f~ '~-:-~:J}~. ~
<br />
<br />DATE OF ISSUANCE :c? =-_ ,0:" .. :--p"i;", ~-'.
<br />APR 0 7 2006 P~~f ~ . TAN""i!y"$.COOPER
<br />2 O. 0 ~ 0 3' 4: G t;-: '~~fA$$i$lAfiTS!AtE:RE.GISTRAR
<br />Q ';:'#~ALTH'ANffHUMA.N:$ERVICES
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