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STATE OF NEBRASKA
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA D�PARTMENT OF HEALTH AND HUMAN S�RVICES, IT CERTIFIES
<br />THE BELOW TD BE A 172UE COPY OF THE ORl'GINAL f2ECOR� ON FILE WITH TME NEBR.4S�CA D�Ai21"M�1VTy ��" HEAL7`H AND
<br />HUMAN S�RVICES, VITAL RECORDS OFFICE, WHICH IS THE LEGAL DEPOSITORY FQR VITQ,�°�E.CQ�,S,� t.,� � a
<br />DATE OF ISSUANCE i �. ` 7�..i+ � i. ��� p
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<br />STANL�?'. 5. CDOP,�};,,, , -
<br />OCT � 7 2D14 AS,�.��,�T AT� n �s���a,�� „ `�°
<br />2 o i o o s o i� oEp��MEN���r���� w ,� J ;
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<br />CSiTO. NebTa8k8 �r�.� 95 Mos. o�ra Houns M�Ng. 5eptem'6er 3,
<br />1909
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<br />Grand Ieland 68801 Hall
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<br />$r.rri.e,nut.apara�.o Ovnec.w aoncrc.e awMmwn Marie H., Tagge
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<br />Wiegert Cemet�ry, Grand Island, Nebraska
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<br />`D�c. Gerdon J. Hrnicek, M.A., 'J24 N. Custer. Grand�'aland, NE 68$03
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<br />Lot 1 of J. fl. Hard�r Third Subdivision, Grand Island, Aall County, Nebraska.
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