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Home My WebLink About2178 . . • . • . . , . • . . . c~7.ti.A.~ ~ ~.'~.2~.~rii ' ~ w ' . . . ~ . ~ ~ ' , ! • . • ~ ~ ~ , . . . ~ ~ . . , . ' , ~ ~ ~ ~ . . , ' ~ ' . . . . i ~ , ' • ' ' . . ~ ' , ~ ' . , ~ • ' . , . ' . . . . ` . . . . . _ ~ . . ~ ' . . . ' ' ' , . . ' . . ' r • . . . , . - - . . - - - - / ~ ~ ~ ~ f_'_ •S. ~ ` ~ '..I~C...r:-::~+r:~.s...J..._...:i., ~.X. _ . ~ .k ~ u . _ Z:.~ . ~ ..~~_l ' . ,:.1 ~ - ~ 'J , . . 128312~ ~ : ~ ~ am~sucr o~ coLV~ss~? a~ o~ roai.tc x~'~x . iai / . ~ ~ ' CER?IFICA •OF DEATH ~j 4, 5 9 9 ~ ; ~ ~ . - L' . . - ~ ~ ~ . r, i. tcaca o~ Dunt r ,T1,,.. . ~+AUC oF ne. on a+ w - ~..,u.R .+...a..e .u..~.) , ~ ~ ; Washiin~ton. D. C. /,t~b"10 05 ~fAL - ~ L vsou 11L~mENCS wAa~. 1«...nl G.~t. l ia.rit i.»: Re.wJewct a«. rtw~.tr. ' i:• ' a. STAY'~ b. a GiY. WN. OR W~',ATIOfI ti~. . • , ~ ~,,~~0 %~~6 ~oq6~S. ~T7~~ XZ ~ O~~~T , w 1S RESID iNSID~ C1iY L1MRS1 1. IS RESlDQ1CE ON A FAR)it ~'n ~ ~Slv/~ ///~ya~.to osf yj'l~ai~ ~/o, ns Ho p ~s o'''°~ ~ ~ c~?re u n.,, r... t in• ~;e ~ ~ 3. 11AIR Oi p"'~ ~ i. ld be ancc~scn . D Sd litd. (Trs~ y~~y t. DATE OF BtRTH . AG Uwt~e~ o:csa nu v vxw + aas t? • - i. ~pt,qtt oR MC6 f. r,~us pr~?+~*~ Q w?tAdas) x«~tA. n.r~ NoMa Atw. n;. ' .ne.s M~ O o~'/~i'/90 r . _ Rt.E YH 0 i~, ca,zze~ oF wxnT oov~rn+m st; IOa. UAL OOCUPA710H .(Ci.. k~i ~1,w.4 t«r lOb. ~LN1~1. ~d11StI~IESS OR 11. Bt CE • n) ~ ~ p~s. ~.i .a.t .,.wl~.. hJ.. s.a.1n+.s1) ~St °r. ~!~y~` A . , ' ' . . U 1~. !l , I eD t~ ~ 1~. NAItE OF SUtlVIV1NG E l;; ~ lxf. l~o. F 5IiA1iE ~~I~~ ~~E y/~Y . / s~~i~~~~ . A~S 16 SOCIAL M NO. 17. IIIi0~1lJ11f f R3LATI01~Sd/P !'0 ~Af~'BAS6D ~ ~s. wws n~r?see ev~ u~ v. s. nnrim Fc+~* ~ pF,BSo~/• ~7//FE• i` ~ (Yp~ M. M YR1oWrw) ~J ip• I~N t~tM 1~ N~'N~~) /~-/D- ~.r~cnit. ~a«a. ` Y:~ y~ov 10. C1lVSt O! OLJl77t IS~Ie~ ~ty ~+s nw~ lda 1~ (6): ~(~)•I ~KS~t ax~ ~c~tM . • PART 1. DBATN WAS CAVSF~ DY: • • %C% _ . tr. . II~IA'[8 CAIJSE IaJ :t . C«~titiw. U. w. DU8 7+0 ~ vAirA ~ rw t~ ~bo~s nws (s). t d~t~M tAs w.tu- DtJE 1~0 l~1 SVB- 1 n~w I~se. 'r PAR? 11. . 4T11ER d10N/PIC~NT ~ND1T10NS oxunvtun w wnrt sar wor w~s s~ tas sm~xr. Mwss wzs~T~ o~cr ur ~u* K~) r:. ' . T I F I. 0 19. w~FOn '~~t Y r- .:A'TH ~ . ~T- . ~ . ~ p BL2C ~ 20p ~1DE ilOW INNRY OOCIIRRFA (t~ta w~tw ~J wial? K Pw~ d'uw Jt.) ~p .a ~Do. AOCiD£NT SV1CiD8 H01[1GDE • , j : ~ O O D VIO• .w . ..r . i THE ~ ~ ; tN1uRt! p C'YK. l~OWN. OR IACATION 0011l~'[Y STA'iE THE =pa, L~ :itY OOCNRltEa ~0~. PL11CE OF INN~1~ a«~bwt A~~. ~ ~ ~ CO- M~. l.ea.r. ./ta ~ur.. • . M ~ tMl{i IT O!M rYY O "r . ~Mt 1? ~MK M Od iMl M'A ~N O/1 - ~ 21. 1 atMid~A IM MO~~M~ !t~ ~N~ ~ ~uM s1aMi. , : ~ d ~ o~ 1M 1at~ st ~M~a ad M~ 1~s1 d sT Ia~w1~d~ f . 240. ADDRtS.S 22e. D SIGNED ~ • D. C. CORONER' fFi ~ -Zd ; shable , - ~ D' ' j ~ mpsis•~ Y ~ronY noi+ ~cr a... «a~r) ~1tC 23a. BUHlAL ~ l ~ /u1. G7IEMIATION ~ J~ . 1~~~' Irw C!~ L~" 'I`~~'Y ~/~Ll./ ~i L~. ~ - Rt]COVAL ~ A 'S ~ - 4. IIDIIiT~./`.: JF3~ NU116ER : ~ - " ?A. t1/i/t71A6 HONE ~~iG~G _ ~%t• 1- ~ ~ l 11DGlSTRATfON~ ~ ; ~ : ~ ~ ADD$~S . ! ~LJ ~ ! ' fr ~ ` ~ ~ r ti ' ; ~ ~t ~ f1oOK ~ ~ ~ i~ ~J l~j~ . 1 • `J ~f : • '-f . ~ ~ - ~f , 1t~ ~ 2 ,,5 . ~ ;t;~~ 3 . . ~ . ~ ~ , f A ~ ~ ' . ; ~i • ` : . , ~ I ~ ~ . ~t ~ - • . . . - ! y ~ 1g a~~~ ~ ' ~ ~ ~ . . ~ ! ~7w ~ . . •'r .-':•/-~eA aT ~Y7~:•.r;.~l~ ~,at.~.--r.~+.~t~•-'~':~?~+a.,~..~~~ .:d'• t~r.1r . , ~ i'1' 11?~"Mi ~~~~L.a: , ~~}~~~~~1~N•~1! ~N . ' '~«•¦T~ v 1~y~~ ~ . . r ~ . t• ~ ' ~ ~L~ •3 0 , P , . ' ~~rovided it beatS~'t~eC1~Rb:a~k~bl. ~r.~tl. •of the D.~strict: of, Columbi~?_ ~itncriL'.of f~i:blf c ' , ~ : ~ , ~ , ~C ' ~ 1{ealt~ arid shoxs no evidence oP sra..-uxMs or altera~iona, ~t".~a.certifi~ed :~h~t '~t~e above .i~ ~ ~ 1i a true r~d eorrect reproductioq o~ the oiriginal ce ~ificate fi.lec~J~~`~"V3t~sal:'3tatistics'~ ~ ~ j: Soction of that Department. ~ - . . ~ 4 . , ~ i • . - f~ ~ ~ , . ~ . ~ . . ~ - , . . . . . _ , . ~oR• ~9 P~c~3`7-r ~ , . ; ~K ~ ~ ; ~ . ~ t . - 6 ~ . . , e~ro . ~iartcoli ' ~ ~ • , ~ , ~ ~ . . ~ • . , ~ ~ Chie f, ~iita2 Stati~ticg SPctio-~ `'i ~ , - - -R rr - - r ~i'~.L'~ ~ . - - • .