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~O•tt~ ~0~052 STATE OF NEBRASIU--DEPARTMENT DF NEALTH <br />BUREAU OF VITAL SIATIS(IC5 <br />CERTIFICATE OF REATHl~, 3 ~; <br />DECEDENT-NAME f{R£T MiOplt 1ASI Sfk OAtF UE 6f TH (M. p, T. ) <br />llortuld lain llittolt ~atiule s,EU2E t lu, 1y84 <br />1 ~~-~ <br />4CE-ftq•. WbxR RiRA£, AMd<knalE]RlG 4f0E5CFNi b tai Me awn. GE- t~nRa ~ UNDERT 1_YEAR~. UNDER 1 PAT D3if Of lltRTH (.Mo.. poY, Y<) <br />fnd+Rw tR 1(£(+.,dr) C` MOS DAYS HOURS N5. <br />lIu_te 1s rs r .)i f Irr ) 6i (df, a rla3E Ll, 1)11 <br />CYR i~N6~lAEf 06 RMM fff nst I U S i~ ~C 11i[N of w»wY <OUNiRT MARRIED. NEVER NRIf D. NAMF OF £('OUSEf I +f y- -d nnwM.j <br />nuM-~_ountr,l WiOOW U. OIYQNC D(Sp• / t <br />;3i Lulswl ck I;e ~y LJii l,D 1~cLlllut~ ,f tl.:llt. uilln YiLi t:;on <br />56CIAE SECYRIIYNVMRFR USUAI OCCUYAT Jn ((. t.nd ol.a<L dondJ y I lK1ND OE BUSINESS OtiNOVSTRY COUNTY OEDEATH--_~' <br /><d ~tmy Afe . J d1. ~ ~~ <br />rz>Ucs-jb-l11O2~1„~Het1rE.« I ~::yci:Ell (_ ' ~,»__lluul.th service I.n a~ Gosper <br />G71", TOWNOR IOCANOM (K DFAIN ;NSIpE CIiYI U41 OSYU IOq OINFR lNSi1fUT10N-NRM•(11noe~n.nh•< U»OY OR INSI ;M;<o.•GOA. <br />`(S ly Yne N) y.•.I+ inl n,.mb•y Qvrpwi.wVlw.e tn.!•pRnYM (SY•+'JrF <br />tm 1•;lmOOd _!i ,iu ~1 g YuLn.;uli L1:e , lilttoud,IJe.,,, <br />IIESIDENCF -STATE COVNTY ~ TY tOwN UR10GAIfON $IREEl ANp NUMBER ~~ INSIOECITY lLM1T5 <br />(,t>S;l7er t rsp«+ Y fr Na) <br />u.lieUru~ka fw _-~__'•~ 11 1:1+,uud sdJol,rt~ou s L:lke ISd. ~70° <br />(AlilE~~---~NKRIE fIRS! MtOpIE LAST MOFHER-hUtDFN NAMF FIRST MiDDIf ~tAS~E-- <br />~ _ "•" ___ ,irtiwr tiut:lor („ _ "_iae _ i'vat>G'eline T'1u11iri <br />_ t Ili t+ ' <br />WAS DECEASED FVER iN U,S AWED IUt<11+ Nt UA/nANi NAMt AtI AI;IJN]n1Y nUllaNC: AOpRESS ilrtttl OR t,.G NO. piT OR tOWH, SiAIE, LMt <br />U°a, n° . ,nti uw °r <br />ra Yes +tor~d~[dar I? 41-46 _iY:,r... :•li,E;le t;aL:;o,l-~~uaE:-JOhnsOnts La1:eR i:1NOO(lE iJe. <br />-~-_~ ~CIMEIfRY (iN CREMAIUtx ~~ -~- " <br />EUdAI, C<YMiYA, hmwall PATE NA~nt IOCAiION CITY OR TOWN STAIF <br />I <br />ro. -iul.__ lam dl.•?11.~•;0 .f~-'_'.lu<1 1:a:up~ ~C:'L(~___-- grad- ___GraTtd SH1~7d Iii <br />~f.{ 1-SeGdbtifME L l!C N6 l v Ui j tlinkRAl nCiMt- NAME AND ADDYE]S i]t.fki OR. f O NO. CITY OR rOMN. SIAtE. tIN <br />2~,. ~~ ~C-~L ~;,,L.v:,:-".~~,,~f~ Si)na~•r:::c"uu:'::,~U,~ ' ;.oeni~;, Grrutd Tslu.zidE Tie. <br />_ iSGS_:~~ <br />o.r b.+ • «.•.-1+., d.w :a .: w: L_. ~....,,~ ,.....,v, .e. ~.. ~~.. -- ~ - - ~.., .. -" w;w «.... W..,°.. ; w......~ d r <br />~ <.wyJ d.rd ..T' ~ew. r~... •wd .iw•.M 4 ..iJC+. F, /f <br />_v 22..(S. ..t W 1. +~ ~D.~-.O 2W .or , • / i L~•.~Ci.. l.G*' <br />,{t• DdIEf SIGNEDIM... Poe"Y.1 iHOUR Of pfAtN-- - ~~-"~-"-__I ~'~ IDAif $1GlI~D (~t>MM• N ~OEA <br />°. _ <br />!~d nr. ia'-` --- _--- M (~~_ °~a.e~'llCn3gt ?Fs. 1 ~R!?.a.° 9:30 A. M <br />[ __ ___ <br />>EaE W.If EY DElEM 5MC. 9sT.r^ i+n0 YRONOUaCE00EA0 PRONOUNCfDDEAD(Ntw,1 <br />~~ u <br />2 T _..____ -_ __. _ i . _ lyd laucntst 20, 1980 2... 10:15 A. M <br />NYM ~ •DWE£S Cw CEi1fi1lR ;tNY52rwn tOtONER'S YHYSICiAN OR COUNTY ATTORNEY} i I,p• o+ PnnN <br />Carlton E. Clark, Gos~er County Attorney, Elcx~od, Ne. 68937 <br />REG1514F ____._ ~ .- -.. .. -_... - -. ---.-_ DATF REC EiYfD RY tEOtSTRAt (MR_, PoY, Yr.) <br />aR..,a.,....N- ~' >•r1 ~1LZ.V=III-1 __ 2d September 2, 19~Q <br />27 Ywep1AIE CYJSE ;ENIEt NiY UNf CAU EA t;Nt ti)N I..i b/. ANO f<+; ~ Inn..c1R«.w..•w..d bMi <br />GNI parent itE~rt l<ulurc- Immediate <br />OW TO, p Y A GOtFIIW EHCE O, ~ I.r...l b«..°. +..« .r dwn <br />.Rt -_ _-. _ _. ._--_ __--_ ~ <br />OYF TD. oR wi a tONStouteK[ w-- .....1 t.<..~ ~....r d..+ <br />fa <br />rufJaitt'iF'iiawfle.rrew.orrw.t -<w.............w...,, .. •.... ,....., .«.» r L r .e...°.l w to .. ~--'~ ~~T~1 1 Cisc Nit:uu ro`waCM <br />R • i rtt w.w<T w nt ws~ 1rJnln» w r.. .. n.+ ~ tt.v.;nt. 0. CgRUwft <br />.. ifR.f+iVo_ ~IZU_a.aH.r Yes <br />»., ..t . <br />.ii,Mni~twiiut: wori+a'i».w t-~a.~. .s ~n,w,.... ,.,.. ,., ...,, ~.n,,.< a.u.t wo..-...,w.'ac: n...u <br />De PeR.lAnc <HTaam.rYr. F:,~..+„ I <br />2D. Natural ' TGb ----- ----- -------- <br />1 m M ` )at <br />wun AI vOt n.[f gf~in,>rii ~ ,.... ...».......r i,~yak,,; -._. _.__ smu (rt t f b n. ctn a rDYfw uAit <br />« .w <br />1Sw/v TM MN.f .tw a••Id~+Y. .'• :>wW.. ~ <br />No. ,a _ !;t lxx;u -- -------~'-Dy-it.it_l, L'rax i3G, lil~.+ux1, :d+::. f38J37 <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA <br />3?ATE DrPAlITt1EN'i' QF llEALTH, 1T CER1'IF1ES THE ABOVE TQ BE <br />A TRUE C017Y OF AN ciRiCINAl. REGO"Y.ll t7N FILE WITH THE STATE <br />DEPASTME*~T OF HEALTH, BUREAU OF VITAL STATISTICS, GSHIGH <br />IS THE LEGAL DEPOSITORY }'Oit ItITAL RECORDS. <br />~~= •.ii <br />DIRECTOR OF VI'PAL S'i'ATLSTICS AND ASSISTANT STATE REGISTRAR <br />LINCOLN, NEBRASKA 1s~,tltd `.epLelldaer i«I, I980 <br />The East Half of the Southeast Quarter (EASE;) and <br />the Southeast Quarter of the Northeast Quarter {SE~NE'~) <br />of Section One (1), Townshia Nine {9) North, Lange Ten <br />1;10}, west of 6th P,i4., Hall County; Nebraska, known as <br />the Don.iphan faxnT, subject to a life estate of Donald <br />P. i+?atson. <br />!___ <br />J <br />L. <br />