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HomeMy WebLinkAbout1657 r.,, - .r~ts .o~. a. ~.TM G~RTiFICATE Air DEA7'H ' ; ~ ; a i ; 1 s•••• , w~s~?u ~ wr~ t~~t~tr~ t!~ ru.~ Mo. l~~al ^~y- ~Ti~~Y~~ •r r1~• ~r~~~ •t) { KJNt M MA~M CObL NP. . M~L ~MMM~t(wMrrYrr+iMwt qM.~ri. I~r~~M~w~W+W • s w t: s 1 ~IMPI~? ff~1[ 00{IIR~ •¦a ~_~i ~i - . ra~. a~ ~our~ c. a rt~ a ot~rn e. cm. rpr~. o~ wu?no~ •~~~e : NaiOE CtYr LMIIT'f~ Mr10t CITY l~frif til~- ~ ~ ~~Tal Olt (1/~wl l~ M~/Md. IM It?Mf Wr~M) 1. fT11[!7 110011ElS ~T(~1~T10~11 !'Mx Af1Mr lw~re 1 d?T[ ~wA DN YMr ~ iy[1~ J.N N ~ATM A ei ' 6 ~ . 3[X OOlOw O~ ~ACE YAMIRD ~ MIKR MA111t1E0 OAS! Oi l1RTM Mf 1 /rO~ 1 1~ trt M?r~M/ rw. ~ r~.. t• . 1[ 61 a~ 16 1 6 / 1~! s 1~ 1. IfiU+tl OCtiil?ATiOM (piMt tlr/ ~Jra! Mr la_ KtM00I WfUlES60R MOUSTRI/ 1.~1~111'LAQ (~W w~ psfb"/') C~f~ a wMT ~n r i t~ 9• r- trrly wwt N w?t1q h~. ~re~ ?~tlnU r~~~•:: ~~'~~l ~ tr ~S ~~~i• ?l~~r !f! 1 . ?~11K11'S MA • . 'f MAIa11 ~Y?Mt 0. l~faltsr 1~ r~ Iau ~.lrr~rL t. wns o~a~co cvcN ~ u. s. ~utrco ro~ccs. yocuu xcu~rt,r ~o. s s~r~ JOhrt F. $ya]C'! ' t 1'.. wh.+.~ ~ll r, w. w. M~-. w r.:a - - . _ ~ -0 20 Pi~ • i /~a~ _ a 1 t~. CAN~ N~1 AM+ wql ~wr aw ~er Mre pr (S). a~t (e).~ a1 r t. r rARt t. OtAtM e,?S u?ue[o ~r• otATM ..~e ~is. ~~rEO~ri c~u~c c.) tl"~b11bi1~ GIl"~ill~ '~11"Oebo/1• ? tr• :•r- C1C! ~tf ~ • . •j..' prEfrtss. f/p/. ou[ TO 4f - r1t~ tM• ~ ~ ri1f " • H~ictr~t ~ OVE TU (a) ~ i • . ~ . • 1 s b' n 7 i ~ HY~r I~M. . - , ~~~T cx~ l~swrrc~n toarr~s oowe~?rrw ro ourw wrt wr ~n.nRC to rnt raww~ oau~[ ca+M~ M~ ~ N~?T n~) ~ i~~t - • h ~ - ~ - _ lW~1K0~ t~r • ~•tY ' tltti(J;~yp? fe~• ~ DflC11i~E MOrr ~altJriw OCW~RfO fdS~fn+~wrr Nly~r1 h ihri r•~f U ajY~+r I~J :.ti ~ •~tt i •~1 ~ ACC~O(NT lU1C10E MOY1[t0E . ~1~~..~~_ - t f~¦ ~e. TrrE OF Nwr JIfwN. Dy. Yar y .~~Y'- _ t'~~7 NYURY is. ~ ~ . • ~ . • ~ . . . . ~t. M1luRY QCCUi1Ri0 !0?. ?LAtE Oi IIUUN~ 1. Iw r~Dwt Mwe. G~Tt. YOrr11. dt LOGtTK1N ~ STAT[ '1MIIt At ~ 11DT NmR.[ ~ !a*~~ trNt. ~e+ 01t/•. eu.) ~oRlt AT wWtK r~. ~.ra~+~w e~. ~»....t ~.o.. _ 1~T~P attsndod tbe dscaaaed ~..r .~r.M a~ OwtA ~ootirnl ~t r+ on tM r~N ~tabl ~ior~: ~n1 to tM /wt ~I wy Rne~1~/h. fro~n tha e~uwr ~t~M. ~11 ~4~~• .N~M~~Yr[ (Dar?M~?tYYttt) A6 AOORiSS 3~ D 't i• - •••r: . D. R~ss K.D. t~ort St. Iucia ~ Ctr.P't • N f 119 F R1. ~~tt MAME Of GCMtTfRY OR C~EMA7q1~ fl/. tQCAT (GY/. IwM. Mr~) ~ s~+A~ 8orr?~a 8-t8-6 ~'t.Msrc~ C~sta 1~'t.Pierc~ Flsr'ida a. r/ e t t t~. sw+t~TU .~L. t.~ o~rc ecco. ~r wc~ ~ae. . RcsaT~?~~s s+sw~ ~ :sas lnlt~at i~. A~?1td F't~.Tiero~ 1~'a.a. $-2dJ-b~ A~na I,M D~11si~r1 d.r. 1 F~ral~y~ cestify this ~o be a true and correct copy of the tACa~ F~ L€ D~?N D R E C t9 R.B E D {tpistrar's record ~~ile in the St. luc~• County H~slth t~pa~t- RQCO~-_. ~ 0 0 K : ment ~t t~ott P:ert.e',,,F(rsrida. 4 ~ / ..lb'~c (V1/arning: Not ~rc,~"~`unfe~; r~ise~ se31 ~f tha St. tucie ~C~ ~7 ~'yl ; 08 Cotmty..Ne-•,h be~~~~t:rer~t is 3{11XC't"~.) ~ ~ . . ) . .1,~ ~ N. D. M!LL:.R, M. D. ~i0li'' i ~ g. _ . C .~f;K County Fiealt~, Off.cer d~ tocal Rsgistrar ~a~. ~.1J 7~ j~ T Y. ' - ~LOr~tt~a . • ~je.S~ • ~s. !~l~s~5~ri.c~ ~e'hr Ds¢~uty Lor~a! Registrar d.,r- @o.~~ ~ °p~1~~ 455