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HomeMy WebLinkAbout2217 ~ 15y14s C~r2TIFICATE OF DEATH " s"•• ' • . , MICNq11N OpA~TYEIR N ~AITN BIRTH~ No. rnN t.ati. s«a.. i..N ro. N.... H- ,l~ . ..~,....-«..-,.....--.--.H.....r....~.t..~..~--~.,:A.: - - - 1. llAt~MTM lATN rt1` ATi i~0[NC~ 'rrwt~ ~.ewa n. 'i i~~~~ wa: .«~e..e. ww. .esiuw~. i ~ ~-Clir 11f wp10~ ~stfMN~ 7fN4, ~tlt~ AIIRLL ~~A rtb ~~TN 10MNSIN~. INiN U! 1~ R«fOre~ s1~au~ lt~~~~ K V YttlACt ~ww~~~ ~~q• tAU wn~ CIiY 0~ ~ cus aw .uMnf YalAU ~ TM N~ ~ 1. lult 111U1[ 0/~1~~ ~~il ~tu w~~I~w~~, n,• Ke.ri M~.w w Mr~uNl i~[[1 _ Itt nh1. e~n Mes~w~~ u ~ M~~~.~ y,e~_v_iork l/ae ' io..~~ 7.~16 N. ~smuTaN - - ~ ' ~ 3. ~ E S~E6=~-Aa~i_-IP1rq1 ? Ifii,lol~? Il.utl ~ OiTE IYMt~~ IW71 tYwl 1't1N~t Rletl ~ , .Q ( DEwPI e I / ` 0. SEII COIOR OA ~ACE 1. MARIIIED. NEYEII IlAIltIEO. . ATE ~1tiN ~Is seu~ ~ It rwn'e~_~.u lt ~~.i.r ~t~ t l~1at.~e I l~e.te I w w~~EO ,I ' 2 ~88'1 . I~,.~ f,,.ri u~. i M~.. ~ tA. YSIIAL OCCYrATI~I ~~:~w una ct ..rr I 1M. pi0 OF WSr1E3t M NIOYST~Y 11. WTII CE /sut~ w/wWa cartnl I 12. pTItE11 OF MMAi COlIMTlr1 y N .lur A~Int e~+t ot w~llat IIfwHM tt (Nlte~l P ~ ~ ' t 1~. fATNEt"i Mn11E i1. 'f YAlDEII E . N NYiMII~ 0~ ~Yt OF ~ICEAt[0 a z ~•l F. Lo~o~_ I Akri~ ~ ? - 1~. IIAS OEClA'SEO EYER ~N Y.i. ~MEO iO~CE- i~- 1). iOCl~t IiY . 1 .~FOWANi NMIE ~ U Ett {M u IY.+. ro. ar ~tee.e~ I ~If sh. etM ~u ~rd~~n at Mnfe~) I ~ /I~ ~ ~ c~rst a eat~ • c 10 , '.~:.w~:w o:.u d = r~~.r ~.r..s.....• n.r 4 D1SUSt Ow CONO~TION ~ ,/~i~f/~'~/' , 1 ~ IIM fef f~i. fs~, Md itl DI~ECTIr ItADIMY i0 0[AiN•(~l ~ AM?ECEDtMT C~USp ~ ~ y ~ • iW !aa Nt wu~ tN M~~ie aMiue~s. tl ~~11. lhMt OIIE TO tf) q ~ tiM ~t h~p. s~ as M Wt rIs• 4 w aNv ta~ r~? st~tU~ • ~ fsYw. ~aMsN~. ~h. It tM wNdfnt taos~ I~sR Naq tM OIN~f~. Mjrry M ~ ~~NlatN\ wYN uuM ~ TO (t) ~ R. OTN[R flCllaICANT COIbR10MS • ~ C~~ditiNf tNtdMM~ b dN dNt~ Nt Mt ~ ~ W rwtN n w ahas~ ~r aMroo. ca.W~ Matt. tJ 1N. 011iE OF OrE~ATqN ~ 1N. YA10~ F~IONaS Of OrERATIOM . ~?f0/SYt ~ - iN ~ r~~ Z 21~. ACCIDENT IROeclhl l1~. CE OF IM1tlRY 1~-r.. 1n et ~eo+t ~ 2~R (CIIr. rlLACE.OR TQNMSM~) 1C01MTY1 (tiATE) SUICIOE tx,~~. hn~. taetwl.nrect. Mk~l1Ae..a1a1 ~ NowuoE , • ~ ii~. oxFrE ~N~~s~ ~n..? ~r..~, ~a~~ 21~. MMt~1 OCCIIRtEp 2/f. M0~ 010 YW~~ OCCUtt ~ M1W1T . s. I w~; i~? iiw~~ ~ J r W r tt. 1 ~~nb ry tut 1 • N IM Na 1 , t1 1 . Wt 1 Iqt tw tM /KwN/ MM • ~ ~ M ~_~~~.1~~M M~t M1fi ~m~ ~t ~ . MM tN swN~ ~M w tM hN statM ~Min. ~I 2~i. Y~E ~~knn.e neui 7f~. AOO~Ett li~. ~Att piN[~ . ~ ..~li /jt,tJ / O •t/. ~ • . ~1~, 2~~_ OATE . 240. RA11[ W CfIIfTER OR CREIIATORT tN. IOCA 1C1q. ~U4n. t~s.. ~ esa~q) ~wue~ ~i ~ YAl~l~sw~~1h) I I ~ - . 1~ N, ~ OATf REC'0 ~Y tOCAL REi. iRTW'S S Y! =y, ~ . y- , Jnns 29 196~ I ~L"`~` ~,6° ' a~~,u~'h'~ ~ - - _ - ; ~-----~----t-- M - - - _ _ . . . ~ ~ • - ~ ~ ~ . - i'~~:•~.. . . rr. ` . . . ~ -a ~ 1' ~ . . + L , • . • . ' - . S~1`ATE OF • - . . ~ , -.r . , ~ . . a ' . + - ' ~ ~ , ~ y~ ~ .r ' . . . - . . ~ " . ' ~ ~ • > aS' . . . . . , . CO'JtST1~'~L,~ liA'~y~,~ 'A _ i, ~ '~i~am (~'idler, Clerk oY said County and Clerk of the Circuit _ . - I~ ~r- .t .~oi,~ . _~y, ~sams being a Caurt of Aecord having ~a eeal, do hereby ~o~~•~ - , ~!!Yd~*~nt~~.~ _ j.gQ._ v~v - cb~. ~~~:;t~,~~bov'e.- ~ ;tr'?se copy of the Record of Death of ~ ~ . ~ . ~:and of the Whole ,thereof. . _ . _ 1i.~ , ~ ~ . : ~ : "'"f ~ ~j : ' " : ~ I have herevnto set my hai~d ~ ~ ~ ~ ~ • IN TBS'TIir[ON~G i~A~OF, ~ •s~ ~ ~ ~ a ' ~ the Circvit • Court the 19'~is - ' - _ • and affixed the aaal of • ~,~;~~-,:~'y,~t`'. ~.~:a~. - day of Jnns ~ 19~_• _ - . ~:~P~,;•..~~'~~~~.~, x~~='' • . - . - . .,~a• ~ ' . ~ W Clerk ' _ _.3 , 1~ ~ _ ,i , il De~~~ Clerk p ; y ,c.~~1~czG ' ~ B ~ ~T._----,- ' ; . ~ • - . ~ - ~ ~I . ' ~ . ~ ~ . . Y: . ' . . • • . . . ~ ~ . . . ~ ' . . ' ~ - , ~ . t• . ' , ' ~ , ' ~ ~ ~ . . . T ~ . < . _ 4 . . . . , ' , , . ' FILEO AND RECOROE~ ST.l.UC1E~C0URT~ A V~ ° . P~~o~ .159~-~3 ~ '61 A~~ 15 PM : 5 ~ f . •RK'CIRCUIT COURt B4GK ?ACE221,7 ClE . _ ~ . ; ~ ; - 3>- ~ . • ~ ,