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0578
192~83 . Q~ice of the Registrar of Vital Statistics N' N~ 19 Citr oF O~ange, Essex County, N~w Jerser • . ~ This is to Certify that the tollow-ing is correctly ropied from a raosd of Death in my office. i ~ w.~. a o.~.d.a v~.a e~ o~un ~.n ~ o..* ~ ~ ~ ~Rirt ~tT~' - 0~1ii$ f~iRU~t. 1R'r`:~ZtAL .if1~1N~V fi~ i~$ - ~ sodM s~a~h Mw~b.. Sea I co~o. IWri~N fo.d.~:on wr of ~ir~A w9. ~ Yn. Mos. CMs ~7-69~1 lyio I W+~ii ~Myri~d 0+~;.~be~ =3~ 18~ T~ I I ~ n.~. ef w,~ c«,» ~ o»a, ~ ~N~~~ ~~IE MAtiiNt~i Clf~K- ~~~tt'~ fA ~t~i d~ ~Cl~ s~,v~.~ w~...w~ o~.~. w.. a» a E....~ c.Y.« - ~ Aodr.m. sukta. or Mo~C:e. aM. oF o«~..«K. s?ic~~r YYlrt~ Cir i~wY Otcv?1 u» ow ~o~• couw~~ ~r~~a Oid Injuer Oacv~ in a I10a» Nan~. on Farw~. in Indvstrid Pt~u. fe Pubi:c ?laul ~ ' tIIC~I~ T~?t O/ ~LACt WhiN N WoRf Mea/es of Iniusf ~ NMr of Pasoe wrAo C~li£Nd CarM of Otall~ AddrMS . ° 14 Jo fit ~lM~~ ~~Zstio~! AMl.~ l4~136YPRs q..~. . 5 ~ ~ ~ - FILED AND RECORDEO i ST. L.UCIE COUNtY. FLA. ~ CORf; VCRlf'tE;? ~ '~-~~~s~ - . - - - - - ~ .,~~d.~ 9~Si3 ' . ' - - - - - - - - - - _ _ - - EDwARQ OERNER - ~70 APR 2 3 P~! Z. ~ ~ Regist rar o( Vild Stslisfics ~ o..~at, N. J. ~ H4GEi~ ~ OITr~AS a, - : ~t(~tRCU1T COURT~ ~ ~ - - • 19 ~ ~ . , ~ ~'t~~.: (J/<< Of ni~ 't~ ~ . _ - ~1~ ~ 3~ ' ~ ~ ~ - - ~ ~ ~ - ~ : ~ ~ ~ ~ ~k _ _ _ ~ , _ _ ~ .