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<br />STATE OF NEBRASKA
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA HEAL TH A/IlQJ!-tt.'I!N~ SERVICES
<br />S'fSTEM IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAJafft~ft~~ WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STAT#~s~!lflN}rfHl!;H IS
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. ~.., t. f.~f"2;' ;''''7. i1~. :'.'.~~\
<br />
<br />DATE OF ISSUANCE _ . . tJ,. cO ~:-c, ~~
<br />: .... - -:TANm:s==cf:J!JPER
<br />MAR 2 8 2007 2007028 41 A$$lsT~NT.STATE flEgiSt~R
<br />LINCOLN, NEBRASKA HEAf,TH Jt~D"~l!,A!Jlilf~R,~1ftES
<br />
<br />. _:: ~ .~~ ":'::: ....:..::7'-:....= .
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<br />
<br />"ADOI' IBIIUKA-DlPAIl1MlNrClfIllAL1HANDIlUJlANSIlIlVJCll$ FINAHeB_ SilItaar
<br />Yll'ALSfA11mCS '-
<br />CER.11FICATE OF PEA m
<br />
<br />Sharon Ann
<br />
<br />Berger
<br />. ...'"-
<br />"""43
<br />
<br />Female
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<br />.. MTECW"IIRTH I_Dwr Y-J
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<br />2 SEll
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<br />ATEOF~ ,.,.u.u "'.__
<br />Grand leland, Nebraska
<br />
<br />_. VEAll
<br />!II> UOS DAYS
<br />
<br />UNllIER 1 MY
<br />S<.1lOUIIS MlNS
<br />
<br />January 8, 1957
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<br />DNoIsonQ-
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<br />7. lIlXIl\L_
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<br />.. PlACl!i OF OEAlH
<br />~~ 0- 9~~
<br />G! ER~
<br />0001\
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<br />505-82-7076
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<br />St. Francia Medical Center
<br />~... tnY, TOWNOII~TlOIfOf~TH
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<br />White
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<br />Grand Ialand
<br />... SIODICI! . STATE .. COUNTY
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<br />Nebruka
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<br />Advertisi
<br />FIIST
<br />
<br />Clarence
<br />
<br />
<br />James Berger
<br />IS EllUCATlOIf ls,.c.,.,,,,,,,,~__
<br />~~~r.vIOt2" ~f'''''Ott~~1
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<br />__ AllllABS
<br />
<br />James Berger
<br />'SlAUTQARF.O NO. CITY 011 TOWN STAr.:.2IP:
<br />
<br />4385 W. Stolley Park Rd., Grand Island, NE.
<br />2Il__-_TUIlE.~NO. 21A.METHOl:>OFlllSI'OSIIIQI; 21O.DATE
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<br />68803
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<br />Apfel-Butler-Geddes
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<br />o _Of Nov. 28, 2000 Central Nebraska. CrematiOl1
<br />2'd CDlETERT ()RCF.ll....TORY lOCl.llOfl cnT OR TOWN ST",IE
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<br />Gibbon, Nebraska
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<br />ISTAnT OR RFD. 11(1. CITY OR TOWN, ST...TE.lIPl
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<br />1123 West Second, Grand Island, NE. 68801
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<br />3211 AlGIS1IWI
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<br />W. taM/I
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<br />a"-ll\d IstaAJ. NE "503
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<br />3al DATE FllfO !lY FlEGISTRAR ilIo. c., '{'-I
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<br />2000
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