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STATE OF NEBRASKA
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<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTMENT QF,I-~LA~,TW AND
<br />HUMAN SERVICES; IT CERTIFIES. THE BELOW TO BE A TRUE. COPY O,F-~HE,(JI4~;CN;4'L~~E~I"TRD ON
<br />FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERWIC~S ~ VFj~/.K " EC'C$ ~
<br />OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS., ~ " .t ~ ~ ~ ~ '~'• ' ~ ~~
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<br />DATE OF ISSUANCE .,YET, •
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<br />JUI. 1 6 2009 (A~ p ~1 ,{ asSrsTA1VT ~rA'~'E kf~IS"~RAF
<br />~,I O O~ O 6 0 4 O ~ DEPARTMENT,OF,7.1~A~y'~M SAND
<br />LINCOLN, NEBRASKA HUT4AN S~R~~~'• ~'' `~''
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<br />Nebraska Hall Grand Island 5622 N. t Road ~ ~ ~
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<br />60i N. Webb Road Grand Island Nebraska 68803-4uS0
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