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Tnis e~- fTAT[ ao~c o~ ee~?~~t+ CERTIFICATE OF DEATH
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p r o p e r 17 L Y WAL R[NO~NCt ( D~we Irrnt M.t. /!:wd.ew~: Rw:tw« W..~ ~.:n:~.)
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¦enent Vero BP,aCh "'S'
E`~'T" ~~0 Lakewood, Park p~TM„`o~M~rn
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I. N~~eE OF (IJ Nt 6t ?M~ifd. /'se a6at ~f4w) STREET AOORESS
1'~~,"~ 81ver Nemorial Hosn. DOA Box 3615
3. tu?wc or FSnf NIJt~e Lat t. aTE Na~t~ D~1 Yen
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~.f,~~ LeEoy C. Schwier ~TMNovember 22, ~968 ~
S. SEX 6. COIOR OR RACE 7. MARRIED ~ NfYERMAR11~0~ .~TE Of MRTN 9. 16E~(I
u~) ~~4R a~ Hwm~ X~-
~ ~ i~. A'iale White ,~,~p~ o,~,~p June 2,1903 ~~j'` ;
p 1 a 1 n 1~ 1. trt~ Or ww~t cawr~r+ :
IO~. USUAI OCCU~ATION IQ~/t HR/yl[M~ tMt 1~. KINOOF WSINESSOR INOUS~NY 11. ~1NTMPLACE (STalt 0?~0?tf/R Mtwh/) -
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¦snant Public korks Washington, D.C. USti
Dlnet lak ~j, ~ATNER'S ttAME 1~. MOTIIER'S MAIOEN NAME
tTD~~~it~~ John Schwier dnna Stocker
16. SOCUI SECURITII NO. 17. IN/O S NONATYR[ AIBat i
78-10-2271 Nrs Elsie M. Schwier Box 3615 Lakewood Park Florida
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1MXIlE AT ~ MOT w111E ~ J~~. IattN1. X~tff. • tt D/~ dt.)
MORK AT NOIIR -
21. 1~tt~nd~d tl~ d~ews~d lrom o ~ nd 6~t w~ ~~.m ~li?~ on °
pN~h on th~ d~N at~td ~do?~; ~nd to tM 6Nt d s+~ knowl~A/~. from th~ uu»~ ~t~t~d.
111 1te~• jZy~,~i .tATU1K ~.(4(r) ~ ~ ~ 22G ACORfSS ??t. DATETIGNED
t~ 7 ! 2p~~f Vero Bea F 11~25/68
coaylete y '
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~ ee~r~te. ~ F~4~ LREN~TtlM Lb Dl1TE jk N~NE CEMETERYON~ ATpRY 23(. LOCAT1011(GSf~,fwr*.MtMt~t/) ~SZtlt) ~ ~
~~g~'~~h' il/25/68 Hillcrest Memorial St, Lucie Ca. Florida ~
n. s.! e~ s 2~ ~u+~ea~u a[ ae s sw~uTU o ss 2S. o~n rtceo_ sr ~t REC. ~ riu?R's sw~uTURt ~
Ae~. 1066 ~ /fK~ . ~loyc~ ~uneral Home ~ f A ~ ~ f ,
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"I hereby certify the a5ove to be a true and correct copy of
the Local Registrar's record on file in the Indian River
County Health Department at Vero Beach, Florida."
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Thi~ is not va2id unless the raised seal of the Indian River
~ ~
~ ^eunty Health Department is affixed.
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FII.ED qN - C C E r~~^
T C , . •
S • IUCIF ~ RECOROEp - ` • .
~~C~:~ ;~UpT FFIA. ~ounty fiealth Dir.
~ ~F, , Ldcal Regis~rar
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68 C~. ~ S P~1 ~2/ 2 l C ~G~i~s :r~: ~
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