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~~ <br />~s ~ ~ <br />~ 8~. <br />qF ~ <br />dates Livingatan , after being first duly scorn on oath deposes <br />aAd-saga that he is a resident of Grand Zeland, Hall County, Nebraska and that- <br />; he is licensed embalsier and funeral director in and by the State of Nebraska;. <br />That, Hence N.' Casper a resident of Grand Is7.a~! BFebras$a <br />did die at Grsrui Islate3~ Aebraske. on Jaur.~zgr 27s 3.9€5 <br />and- that he did <br />prepare the body of Hem ~ Cas~,er for burial oa that date; <br />That, ~ did supervise the bsxial of the body of nenry;l~ Casper <br />~ Grand Isl.a3td ~'4v cemetery, located in Grazui Zs2~su= Nebraska <br />~- daauerv 3E3. 1 5 <br />That, he did see tae dead body of Hessry ~ Casper sad <br />dfd positieely identify saw; <br />Further affieat sayeth not, <br />Signed at Graxsd Island, Nebraska -this ~~ day of Aove~'ar l9 7$ <br />:? <br />,i:~ - ` <br />f <br />Subeeribed-and sworn to before me, a notary public, this ~ day of Hoer <br />lg aa, <br /> <br />