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~ '65 DEG 2 0 AM I i' S 7
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IN RE: FRANK GEORGE LUEDEMAN >7. LUCIE GOWNTY.
~ FLOlRIDA
rn,s Da- iTAT[ eo~~a nR NiALTM CERTIFICA7E OF DEATH
co~es • PUR[AU OF VITAL. ~TATIiT1G• iTAT[ I~ILC NO. -
los~l FLORIDA
o~d rT~h g~RTFi NCI. RE61fTRAR'a NO.
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•nd ¦ill ~~~~~Tr Dade ~3-~d ..sT~T`Florida ~ ~~T~t.LuCie
D• pl~e~d ~
!n p~l'- A. CITY, TOWM.O~ IOGATqN t. IS ~1ACE OF DEA7M t. CITY, TOWN, OR IOCATIOM t. IS RES~DfMCE
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, NOS?iT~ Oll (r~~ ~p~~~ ~~ln~ ~~rdr) LENGTM OF I. STREET ADDRESS OM A FA11Mt
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• i~tir~~a%+~r~ FR~NK GEORGE LUEDEMAN o~YN January 11, 1965
S. SEX 6. CO1011 OII hACE MARRIEO ~ MEYER MAllpl[D ~4E OF ~IRTN 9. AGE (1~ ~tw/ w~~~ ~ rG~ uMDC~ ES WfS.
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D 1 al If 17 ~a. USUAL OCCU~ATpN (OIlt kl~d 0~100/k d071t I~D. KIIIDOf ~U$IM(550R IMOIlSTRY I I. ~IIITHOLACE ($I~ft 9r /Ottl/p t04RfI/) G7REN 0~ wiNT OOUMT1tY1
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¦•^•n~ Product' n M r Fo M t r Indiana ~ USA
Dlaelc !nk ~3. FA7HEl1'S MAME t4. MOTNER'S MAiDEN NAME
or
c~p~.ric•r Detri~k L~l~,deman Marie Walter ,
15. WAS DEGE~Sf D EVE11 IM U. S. l1RME4 F011CES7 16. SOCI~I SECUIIITY MO. 17. IN/OR7MA i f14MATYIK " J
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No 71-05-6104 wa~,t... 1,~ 1 ~l ~Z-~: ~ . , "~-1 ~ J : ,
Funer~l CAUK O/ OWTM (L•'~lt~ ad? ost t~w~ r liiu /~rn (D), s~~ (c).) I~fTERV~L tETWEEN
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r~iRe co~ue tod. 1
~ 1 t ~Sn 71 0 ?ART II. OTF[YI 51C1piMC+1M CD1101TqNS COMTRfqlTMrC Tp UtATN MJf !q7 RELAlEO TO TMC TEIIMMNL Dl'SfASE GOr~D1TKri~ GtViM N1 MRT 1(~) . WAS AUTO?SY
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ter da?th ~ C. ~i ~'V~ 7(~ C!~ t' jt T , j L l% ~ YES lrJ ?'p ?
~ or b~for• 4~~~ ~p ~y, pEKRlif ~fOW ~MJ1111Y OCCURREb. (Bx/n w~tttre ~JisJrr~ 1~ Pal 1 or Psrt f1 o/ile+w //J
~ s.t~ns •nf Q ACCIDEMT w~cio¢ ?aN+ci~
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~ 20L. INJURY OCLURREO ZO[. ?LACE Of INJUIIY (t. p., iw or a~oul Aon~e, 20/. CITY. TQWN. ON LOCATqh GOUNTY STATE
WHILE AT ~ NOT WMOIE ~ /R~^~~ I~Or~, qrttl. e~itt Cllp.. dt.)
WORK AT YYORK
. 21. I ~tt~nd~al th~ doe~~~~d lro~+ I : i , ! I , ro ! ~ : . ~ ~ •nd lelt I~w h~~ •lir~ on . ,
D~~th ooourr~d ~t ~r m on thr d11~ ~Ntsd ebor~; ~nd to the b~st ol mr knowl~dt~, lrom ths uuM~ ~tat~d.
111 ! is~• j],~. f10M~ TVRR ~ (Drqre[ or l~la) _ 2).D ~DDRf55 • 22t. DATE SiGNEO
ar• to D• / ~ r ~ / /
torpl~t• • ,h~~L''~ u: G- l. ~ / - '-/l. • ~ C~.~ ~ /C ~ y/: i: y. , ~ / C. ~
acoue~t~. ~ BUr+tAL.GEr~ .
j{O~; ~p- E'~ 23c. aAME OF CEMETERY OR CREMATORY 23d. IOCATION (CU(, [a~w. or tpusty) (Stalt)
REMOVIIL (S ~t, `
Remova`~~~• 1~~"1--6~ Ft. Pierce C.er~etery Ft,~ierce Florida
Y. 8. ~63A UN£R , OR'S SI RE • l~~~ N. '7 th S ~j'i. DATE AECO. BY IpCA~ pEG EG TRAA"5 SIGN 7URE
i ~••.~oss - Ft.Pi~rce,Fl .//,/9~ 5 ~f~.
- : = CERTIPXFA COPY _ '
I hereby certify the;~above to be a true and correct copy of the
record on file,in th~ office of the Local Deputy Regiatrar.
~ . ~..~-.t~at.. ~ . !
Local Deputy Registrar & Nntary Public, 3tate of
~A~ 1~~5 Fla, a~ Large. My Cammnission expire~ I~av< 16, 1967 ~
a
LAW OFFIG€S
WILLES, BITTAN 8c GRIF~IN $QOK i~~ ~r~~
} P. O. BO% 30~ 1 ~
FORT PIERCE. FL.ORIDA