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~~~ tiJt-145t~ AFFIAAVIT <br />STATE QF NE '~&!-SRA } <br />} as. <br />COUNTY OF MALL ) <br />_t~ na Tom; v~_n~ton , after being firs*_ duly sworn on oath deposes <br />and says that ha is a rEaident of Grand Island, Na11 County, Nebraska and that <br />he is licensed embalmer and funeral directorllvVin and by the State of Nebraska; <br />Tbat, Christina Theasneit~ s °re~s~d~n~oa~ ~ Inland, lTebrasks <br />did die at Grated Zalat~d, Nebraska on Feb. 27, 1979 , sad that ne did <br />£or~er7.;y Dora Loth <br />prepmre the bady of Dpra Christina 'l'hesanvits / for burial on that date; <br />That, he did supervise the burial of the body of Dora Christina. T~aBnlritz <br />in Grand Inland cemetery, located in Grax~cl Zaland, Hebraa~cs. <br />an -_ ldaxah 2, 1978 <br />That, he did nee the dead body of Dora Christ-'na 'Pheaem+itz and <br />dfd positively identify same; <br />Further affiant sayeth not. <br />Signed at Grand Island, Nebraska this 16 day of MRroh ~ lg 79 <br />,;% <br />`' <br />Subscribed and sworn to before me, a notary public, this _~ day of 15artsh , <br />19~, <br />k <br />otary Public <br />My commission eapises 0otob~ Sr 1580 <br />~ ,_, ... - <br />iEGDRDERS MEMQ: <br />Re$. of Deeds <br />,. ~ <br /> <br />