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Home My WebLink About1073 .16406~ ' . _ T~~. ~TATt ~OMO o? Nw.TM ~ CERTIFICATE OF DEAT~ ' RATt /ILR NO. i~ R w~uu o~ w~a?~. ~r~tn~n . F L O A I D A r •f0 •11~11 pl T N. ~ A• N Pr~~~~1~ 1. MAtt N KAfll ~ ~ CODt NO. ~YN:ITAI IItNK11tt~~4~~MrNw~ ~ • Mi4r~dwMwMW •a~er/N ~ , •~it ~ 3 ~ F or cin Bro~?nrd ~1~~N att.row~.o~~oulqN • e rua a earn e. an.~ow~.o~ uounoN a as~a~cc lw ~~h • ~1p~ CITr IIMIT3t MKiO[ tltr 11M1Tlf ••••s• .cs Mo0 a Par vcs~ ~00 ~ti~. . N~M( Of ~M M ~MlMd. iM M/M N~lNI lllq?N OI I. iTll~[T A0011[f! OM A/AIIMI NOS?ITAt OA 3TA~ M N ~sTmrTa~ venue ncs O No~Q ~u?M[ 1'IrM NN~r LMt • o+~it XwM Oq Yw ~ ~n~ Win fred Dickinaon p ~ s[a ~ oao~ o~ w?a 7. wu~u[o ~~cvc~ wwKO a~c o~ ~a1N _Re.r~ r u~oa ~ rw uwc~ MiMNI o.., w..w ~rr.. • r 1 t• NIOpMtp prdlt[O ~ l~ i~ 1~ 10~. uSt1~l OcCUrATqN (14r ~1~/ yNr~ M~w IM. KM00~w~,o~ T~r 1. ~M11MtAti l~dt w A~r~ arMi) tn~ or wMt mY~n~n ~~t~ tw+y.wy+r..~wlyt.«ny•ewM v8ri~ •~~~wt • o ?I~~t fw! 1 ~~TM[~~s M~M[ MoiMG1'! MaOtN IMM[ . . . t»~~~lt~r e ~ wns oca.sco tvc~ r~ a s, iurco ~o~as~ ~oc~+~a xcuRrtr Ma . s~w~s~ • ~r........l...d u~..w a+..?...twl - • ' 4 ~i r~~•r•i N. MIIK N KATM (A1Wr NI/ Mr eMM /r W. AI. wr c~). ~ ~wrc~va ~xca iw ou?rn ~ i r. r. r~~T ~ eu?TM Nns c~wscs w~ ~ •r~t ft1• ' ~ t~ t~• •~f~ ~ ~ ~ .i~i~~ii. ~~tei....~I..r. ~uc ~o h) . i • • . ~ .n.K ~~«x~•~ ~ ~ - ' r.i~.tr•r 3 '~'~'I w•+'~'?- out ro td ' - ~ .ftsf¦ 7s h+'y ~•we I.w. ~ ?~T M.. orna ~ ois~mas oan~nw~ ws enn~ ~ ~ot ~uw~ w n~ w~rr~ ~sa~c aa~rwo~ wa w rr~ K.~ . w ~ .r• rca~aMC~ r a~r ~~~t~ _ ~ • 1~p uol!'l • r?. i~~• ~ 30.. ~M. opa~wt ~aw w~r docu~ca ~sw w.tin y~•t i rrt ! a hrt J y 1r~ uJ ; ••~~•a aw~ ~cc~ocNr w~croc ~~ao~ ~ts~~~~- ? O • tl~• ~f 20e. Tw[ o~ !hr? ~fw~f~. DN. Yw ~~~~s ~ MUll~r ~.1~. w. tor_ ~r occuro~co ~or. ruu aF nan~r ~~1. -1. r.~.e Mw~. m/• tm. tow~ a~ t~oc~TwN oou~nr s1~Tt ~ R11i1[ AT ~ NOT MN1lt ~ N~A.~M~. K?M. ~ot Myy ~Il.2 , MO~K AT NOIIK . /~fN~fMl~cw»Ifwa~ . h ~M/MtNS ~,~fiN~w ~ Dwf~ voe~rnl ~t ~w f1N /~N ~f~f~ dw~; ~M f~ fM iMt oI q~ne~J~II~. /row~ tA~ uuN~ ~t~~N. ~11 it~~~ jjs. N~IIATY (p1?MMNIId m. AOOIIEl3 ??t. W fKMEO 6 7~ ...~~.a. • / ~ ~ r~ ~t~. ' t]. ~a ~?no ~ t[ tk- as aME~r oe e~on~r L1f. uot~mo~ ~eiNr+~•~. w n.aep ) . ~ • r. ~.~~ii t~. ~s s~u? =s.°~ ~ae. w ~ocw a•..s~~~ ~ IVUi. H1 ~A . ; CERTIFI~D COPY ' I hereby oertify the above to be a trus and oorreat oopy of~the Looal i ~ 8egietrar~s record on filo in the brorard Couaty Heallh Depnrtmsnt st ~ Fort Laud~rdale~ Florida. t (Msr~~~gs Not ~alid unlese raiaed aeal of the BroWard CountT Health ~ _ - s . . . _ 'Depsrtaeat i• stfized. ) - ~ `V ~ ' _ ~ i ' ~ _ . t~ + . t.'`,_ .a ~ ~ . ~ •4t•• ~ ~ V 1 • . ~ ~'^tf./ : . ' ~ ~ ' : ~ County Heslth Otf er snd Looal Regf strsr , _ . . - ; • _ : _ : ~ _ . . - Q~,c;~Z~ ~ _ . j . _ - . . - Deputy Loosl Registrsr ' ~ . _ , , ~c ~~~rl ~ T. f L.:. '.'`'(~'~~^.c~ b'/~r t F'~ 'E~ Fr $ . : . 5 : . 0 3 16406~ , ~ . i~. . • o~~ta: i , C! ERK CIRCUlT COURT ~ _ g~K170 P~E1070 ~ ~,~wH~. ~ . ~ - _ ~ ~ . ~ ' ~ _ - . ~ .