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HomeMy WebLinkAbout1927 . . -y FtLED AND RECORDED .16~ ~S ST. ~UCIE COUNTY. FLA. . C^~^ :'~nIF~FD 162`768 ' '6T 7~~ 20 PM 3:40 - • ~)••i i- tlt=~ :5 CL~FtK CIRCUIT COURT rrwTS ww~o a Ms~TM CERTtF1CATE OF DEATH • ~uwtwu o~ vltM~ ~rwTUrrtp sTwn au K~. i•a•i FL08IDA o~d •pea BIRTH NO. REG~STRAR•f NO. orop~rl~ .l~iYNd L rlAt~ Oi O~TM ODE NO. 2. Y~Y~~ Rp~otMttl~~..r~wr.wa..~ t/www. Rrd.ratn~4.ww) , .~a .ilt aocwrr ..art~n ~3-~27 t ST~TE ^lOrlCid a ca,~Tr ; i e. ~l•eH - ~ ~ I n ~~t- C~TY. T01/Il OU LOCAIAM t. .S h4C[ Os OEA~ t. C~TY. TOiiM.OR IOCAT1pN K RES~CC~C[ ••s•.s ~ ~4c1Yt ~ s~r ~'~O Jensen iCdCt1,/^ural ~'°E ~`r~~ : s? ' tll~. t. h~wE OF ~/J~ q MrjiNt. fit ~1r~N ~NtM) I_ STRCCT ~q01USS ~ ~ ~os.~TUO. 3ndian P,i~er nr.,S:ar 2t. ~ u.s:,T„TwN~'arti.n ~'en~rial I?osp~t~~ 3 MAN~ o? flnt ahSlle LsN 1 WTC dIMS1 D~t !ir ? occu?ue Ro~ert La:~rre^ce Too;;er ,~,T„ 13 11 1907 ; t7Yar ~ri.r) s stx t co:a~ c~ ~wcc ~ wuu~co • rcrc~ ruc~tta? • wTS o~u~ TN !.~c U. r~v~ s 4.:,c. +.w u.tta:. ~.s ; i•:ale !;}hite ^ lo/2Yl2s97 tfJ~e~rtw.~ x..w D... K.... x,.. ~ • t 1 t• III~OG~IIID u dYORC[D ~ plalwl~ 10~. 45W1lOCCW~TON(Gotti~~ysMlNaf 10S K~NDOiWSiNCSSONW~YSTRY 11. W1TNK~tE(SY~fe~r~r[ysCM~~WII . CRii[rOS~w?7OOtN~~t? ! •tt~ ~~r- SLViY.~wN~a•tu~ek.n~?~/retvd~ s~~ 1~orc~ali:, ~02112. •(JIll~E.'C2 StdL6S ~ •~n~wt 2~ ~F1C~1t Clllb DlaCt lqk /AT1iER~S M~Y[ YOTN(R~S Y~iDEN lu~+E _ ~ Geor7e Too'.:er Annie S:~nith 1~ SOCuI StCJQR~ ~O. q ~M/OR <<ICru?TYR[ AlVru - • 0~3 07-13E5-t1 i~rs. ::ar~on L. Toa:;er Ir.~=an River Dx., Jer.s•~2~ '~zacr., ~ -i Fua~Nl t~. C~V1[ 01 ~iATN I~tr ~r pe qalt ptr ~v,4? i~1. l'+:. 1 ~U.~ t~7CRY~L ~ET1fEEh . i r~~r ? a~rr r.s us:s~o ~r: ~~1~tA~1~ /1•~.~ (K/" OhSET wM0 DEATM •u~tcill• wrEOUT[ CauSE ~ e~• e~r- ~'1 . ~ citic~t• Ceu~itiw../~~r. ~..~+~/1+~~ •!ti tA~ rl~[l /~rt ~u~i1 ~ ~ TO (~1 , 1• e• 1 tl~r uwe ( /f r~g/strar at~tiiy f4 t~I[r. ~ To (d 4". L..•~l.A, _ •1t1~1A 72 t/W c~aK ls~f. O rART IL OTMER SIGMf1W~1 CONOIT~O~IS COM7MNIU~G Tp O(ATN ~{I* NOT ~(tAl[O 10 M 1FZ~IYNL dSGS[ CO~01~10~ WrLA ~N iNT 1(~) . M~~S AUTOfSr Aours •t- F ?ERfWiY[DT lef d~lt! ~ YES? MD~ or s•ror• ~ ~R~ ~ 20s tDS ocsuuc Mo+~ wu~r oeeue~lce. (Eata ..r.re yuja.~ ts Pre 1 r Pwt 1! yitt~ l~-) . ¦akloi ~ AGC~LE~T S~J~C~O( MOYiCtOE dls~ss!- wi ? ? ? tio~ •i ~ ~ ~ lAt- TwE Oi !/wr ~/M[?, /Ht. Z"tY ~ ?od~. ~ u~ni11~ ~ a. o p- W i 20/ ~l~tlY11Y CCCYR~EO- ~ 20t. KACE OP u+JU11r (r. ia v~o~l y~t. 20/ pTY. TOt/M. OR IOCAT101t OOY!(ir STATE _ wN1ti AT a wOT 11iNM[ O I~N1. YI(d. c~[t OfA/_. ftt.) ~ ~r MOAK AT rOAK I 21. ! ~er~nd~d tM bewu~dl~om ~ ' . . to ~ - ' ~ad lut wr Ai~ ~I:~~ on ~ O - ~ { D~~tA occu~~~d ~t 1 L ~I ~ n~l - tn on fA~ d~t~ st~t~d ~Ao?~: ~nd to tA~ but of m) l~no~bds~. l~om tA~ uus~a a[~ted. t •11 1t~~s ~ ~ICMATYw[ v/?r. t"rlt) ~7 ~ 22+ •DDRE ~~~~~7 ~ •r• so 1• ~ ~V, 1 ~h ~ ~~T, F~~--A . ` ~o.*~.... a i •CtYi~te. ~,~~_~r~1101L j]~ pqT[ 2J[ NiVCOFC[ . TENY0~1C~[waTORr 2](. ?QCAT10111GY~./MCA.Kt~Yqf~) (.~trt/ ~ a~•~~` i~.' :-ort Pierce ..Clorida Cre^~a~ on 12/I3/67 ~ort Fierc F^~ c V. 3. f 412 j ~tC'TOA S SIG1/4TG q SS 25- WTE AEC0. ~Y LpC~I 11EG. ~~TRAII'S S~GIIAT « r~. t A...~oss . c 1 "~tateS°` ~uneral ~:o~t ~ • 3 ~ 7.dr~tc. Pt . Pie::ce, ~lor. _ / 3 G ~ ° ~~t•.~`~~~~ ~ - , - { h~re~y certify ;his to ~e a tr~a ar.d corre~-t copy of the leui : - ~ . . - ' ~L~~s:rar's record on file in the l~~rtin Co:snty Health ~~a~f• - _ _ - ' ' ` ~ ~ rt,tr~t at ~tuart, ~~orida. ~ SI r . - ` ;,i t~ ~ , - _ r - (Wam:r:~: :*:~t vs~:d un'c~s rais~d sesl of :hs fAartbtl ; ~ i . ~ : Couriy N~s::h Ce~~rrment is affix_-d.) ; - ~ ' : _ . - . . : > I!' -••i i ia_ ~f ' _ Z ' • • ` ' ' N. N,~ii~P., ~`A. • _ i t COU~It}/ f:^_dii~t ~ft:C~f ~ ~OCB~ ~i6~l:~fdf ` ' ( . • ~ 1 ~ ~ Daa O~:a:rtY R~,'~;:ar ~ 1[ICB~FIIY 1~t0 ! s k~ibilit~ of writin6, typin6 j or printin~ ua~atisiactorir in ~ d~K169 PAGEI~~Q thia docn~ent for ~icrofilaina; ; ~