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HomeMy WebLinkAbout0202 CERTiFiCATE ~F DEATH ~ • ~ o~.„.~ .t ~ k.uti .~a R~ti.~Ni+~.~~7 0 91 3 9 O F L O R I D A ~:rwT~ F~« No. _ Q°~.~.~..~ ~i:.`.:.o~ ~ 8 j t- trlt. O~ 1fiHi t?~l ~ 1~[OI~TIIAR•! NO. ?ttMANfNT INK OECEwSED-~+~t •~a~ ~wou u~~ OwTE O~ Of~iN ~~u.~., o.., SfE M.INDIQOI f01 ~ ¦snunaK , :~I,l3GltT Yl'LI.U,I !t l:ule ~ Jul ~U 1J7U tA~( ~4. wlGq •rf~K~~ .reu... •GE-~.sr v~Wf~ ~ :.~OH + O~• ~aT[ Q~ ~'f'?1 •.p..rw 0~• uc ~ wtr. ~ i M~[M~t ~.~•~a~ .oa. ~ w~t ~ woun j~Y~ ~ COUNT/ C~ CE/~'M ~ iihite G~3 w ~ uct. 18 1900 Ilro.vurd C1T1I. TO~. O~ tOUtiON d OEwTe+ w~ em ,~,~n ?~psMt~t O~ OTME[ wSi~tutq?~-N~ ~ ~Qt IN ~1~~~. G:~~ SfN11 ~14 wyr~i~ 1 • y o. . ; n • ' Yes ' a~t~.~~on ~iene~a~lto~p~tal ~ ST~tE O~ / ~M ~..o~ v a.., w•.e~GT~ZEN Of w?uT COlX+1Rr w~RRrED. t+E~E~ MuiR~ED. SUtv~v~v('i StOUSE c~•e +.ea.. ..w, ~ow~ ~ ~ ~ w~00wt0. OnOR~ED ~ sr~c.. ~ t ~~w~~~~~°~~ ~ Italv • ' : 1~:?rried l'heresa n ino ~rwur sect.u~ urto u W~m SOCIAI SECURI NU~iER USU~?l OCCU?AT~ON ~6~•~ ~w0 Or ~O~a 00~+~ MM~w rOft O~ RM/O Oi MKNESS OR U~OUSTft OCNHIC u~ ~O~f/O W!. Ffr Y N~~M ~ ' . ~ . . . ~HlnRR~O~+.OM ~~~_n'-~J~~ - ' ' ~~LW+Cl~l~OY ~t V3 p~,. ~b. TOOl all(~ l11@ liuker ~~s .~utomotive •"~'s~'~"' ~'_S~OE~.CE-S'AT[ CJUN?r iGT~, TON'?~ GR IOC~T;ON Msw~ c~n ...~~s ISf~EET ~ND nU~~ER ~ ~ ~ ~ sr~c.n qs o~ w ~N L~'lorida l~r~~ard ~~4 Ylantation ~i.. yes 54~ ~.n. -~7th aveane •atnfR-~+~vF aqt .~pw~ ~.i~ rpiMEt_-wu~N Nn~wE .wr .~ap~ ,~st ~ Jclfino Yiaiali Uomenica llaci~;ilia I WORAMNT-w~wE ~MI?twG AOG+tE15 ,~.~en o~ o w. un w•o~.. .*.n. t+~ 1[rs. :heres:? rizisli ~~n 54~ 47tt~ ~ve. Ylantation. ~'Iz. ~~t OEwM w~5 UuSEC ~1'~ ;ENtEt Oalr Or~f C~uSE ?E~ unE fOf ro~. ;bL ~r+0 ~q~ ~~n.u~ c..u~ .,a e~.r. ' :i ~.ro..r uL~~ ~ . ~ _ i., j . - h~ ~ ~ ~ ?~L L•~-~Cct ~ •f_~ . • ~ ~ ! ' / • ST. LU COUNTY. F'LA. ' _ co»«T~o.s. VFRIFIED .w~c. n..~ ns~ .o (DT ~rr~0uft C~11f~ 'o• D~f ~O. J~ ~f ~ CO+HOrlK! Or' S1~hMG tw! ~u..~~~• ~ - ~rtMG C~Vf! i.ft ~ <<~ 198505 ~wtT N OTME! SIGH~iKUA CONORIp~S- ed.wna.s eo.~rrun..o a oe.n. wr ..o~ r e . ~ nY?OK~ i? rES ~e.r n.o~~y~ ca+- '~~ts O~ MO~ Yoteeo .ti tlrNru+n+V t~~Sf O~ Jt~~w - u• Na ~w ~.~y~ K Ea . SNt A ~~owrw. M?, ~e~~ r 11QW INIURY CW ~ t«n~ wNw or wwer r•n ~ p~ ~.n ~eer-a~ MOMK+OE. C! w+DtiEiw~wEO ~ i,* i~OGER POIT AS ~ • : IN1Wr ~T wOK ~twCE O~ wt~tr.~ ¦o.e. s*wr. ~.ow.. ~ tOC~11(N~ . . . . s~.n ~ ~ ~ srton .es w..o ~ ~ o..~ ~ e.c , snun ~ ~ 7~. ~ :e! ' . . ~RTIf1~AT101V- .p+M O~• f~~{ ~ rp~111 Mt tlY M!~ L~(~wiN~ MM ON O~O~O ~01 v.fr 1y g ~j1~3K~~r~: - ..O~+er .eu w~. .~+arw.m ~ oe.n~ oewueo ~.e ...c~.~i,.y ; ! ' ~ .nt.wu > ~ ) i +ow~ a~n. .•.o ~o +e Ws• 3- '71~ ~~G~~~D70 I7Tt ~ . r~awOrUDG i~.f ~ !h oicas~e ~w. y~ 7.) 711 ~l ~ n., • r ~n.l :(~.~~1 r? ro *M e.vs~ s~ f•.•ee s CEftii~Ut~Ow-rEDrwl EawMU+ft pt CO~Ot~Et o.. +.e ~.s.s a+w .ou~ e. oe.a r~t wewe..r ne.,o,,~.c~o a.e ~ ft~r~..~+.~ O~ ^~f UO• ~r0~ O~ r..~ ~.r~lf~~W'~Ow. n. .~w~W+. ~ rOMtw 0{~M OC(Yrw o.. ~.e wn ..a oyt ro r.e uru~s~ a+~ns ~t ~OY~ r~~ rn 6 ~ ~E~T~f~ER-wwE ~e..~ o..~..n ~ M ~ _ ae r~r ' A C~NEO :rO.~n~, wr. •w~ ' ~/J" rf ~/'~U 'rk - 1 ~ ? %G s MARlK, ADOQSS-GEar~fK~ srN1~ O~ ~ r?..~e~ ro~.. 2, ~ J7/ :^;1 . 1 j - ~tJR14l. UfMAhO?+. iEMOr~I ~CEMkitR~ OR CiEMATO~y-HU~E ~~Li::~J.;,,w un 3~ •o~,. sr.~e ~ t S~KM ~ 1 ~ ~ 'nto~a~ment ~~yNollyaood ~•e~+ ~~ur. ~lauait« Hollywoo ~ Florida D~TE .o.*», -e..~ ~ iVHE~AI MQME-M~ME ~MO ~JWESS t~NR O~ ~ r~. w0 . Cm a•o+«' ~an. eu r - ;w Sul: ~3, 1'~70 l~sirri-l;asc. :ti~5 ~roxar~i ~lvd., r t. Lauderdale. N'la.~::31_ v. 5. 12 ~:avt~~~ n.~ ~ S~tia=~~f ~ELiS~R.?t_uG+.ar~fE i c~tc~ ic:.: :t~:sf~.~ i R~v.:970 ' _ ts~ tw r.,~,s _ _ J ~ , rw ~ ~ , ; ~ 4 - - _ ~ ~ ~ CSRTIFI~~ CG?~ - ~ ~ - ~ I hereby certif~ the above to be a true ~nd correc~ copy of the Local ~ Reg; strar~ s record on file i:. the Bro:rard County ~:ea2th Dezartcent at r; For `~~iidBrda.le, Blorida. : 1..~~1 " : 'a~ ~~~i~~~.~ t•~ 1~/ P ~ y ~~;~iOt valid unless raised seal of the Brov~rd County Health ~ `:;'~0'r, .~eyartaent is affixed. ) ,.`•t s~~•~~R . . ,R ~r~ ' ~ , ~ ~,...~t:~.:.. . ~s : : , ;~~pt~~~ ~ ~ . ` ~ ~~j ~ 1.1 ' County Hcal t i fi cer end Loc~l ite~i atrar ` !t~!p • i • . }"J . . ~ R[C4ROf D IN Of FICUI RfCOROS lOOt 20~ i • ~ ~ r ~ / " ' JACK WHEELER BOQK18~ PAGE . ' GIERK Of GRWIi COURT Depu Local ?e~ist ar , - . . . _ . - ~ . ~~1 1