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STATE OF NEBRASKA
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<br />WHEN THIS COPY CARRIES THE RAISED SEAL,OF THE NEBRASKA DEPARTMENT Q6~H~,4~~W AND
<br />' HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE Q,~1F~",IIV~k RE;C~~RQ ,pN
<br />FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES, V~~'J1A, ~~.~CdgDS" ; .
<br />OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS. "
<br />DATE OF ISSUANCE -~'1
<br />S?'~4NLE .. OPER
<br />fi / 11 / 2 010 ~ ~ ~ o o ~ 8 4 0 "ASSISTT9TATE ~tEGISrR AFB
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<br />LINCOLN, NEBRASKA HEk(,gN ,~SEF21/ICES ,~ ; ~;," .
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<br />STA'!'E OF hIBBRASKA~DEPARTMEIYT OF HEALTH ,
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<br />~P.~• ' ~1 1• arried 1I Bonnie Adams
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