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<br />WHIN 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 REeiiRfi'OtiFILE WiTH
<br />THE NEBRASKA HEAL TH AND HUMAN SERVICES SYSTEM, VITAL STATlSTlCS SECTIO!!, 'WHICH IS
<br />THE LEGAL DEPOSITORY FOR "'TAL RECORDS. '.}m.~.','..."~.'~ - ..-.t........,;.;- '.'~' '~~.'~.. J ":'.'.!W.-""~":~:'. ~::'"
<br />
<br />DATE OF ISSUANCE 2 0 0 5 0 9 9 7 6 -,~i' ~JJA~'etr.::!~R
<br />DEe 8 2000 AS$iSTANT STAte REGISTIfAR
<br />LINCOLN, NEBRASKA 200 1004 88 HEALTH ARI;JHtJMAN SERVICES SYJlTEM
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<br />STATE OF NEBRASKA-DEPARTMENT OF HEALTH
<br />Bu~a. 01 Vi.al Sla.I.llea
<br />CERTIFICATE OF DEATH.!.
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