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HomeMy WebLinkAbout1100 , ERTIFICATE O DEATH ' - -=?7~f1'(~~111N~~~ S~Rt[ O' ;~;.~J_~ : . : ~ al~: x~•.. - ~J. a. RiL'siait~~ b~5!kitT ~~'J : i~f~~~Trllitt~- ~ NAME 0+ ?E~E~~EO-s~~rti?itt'A wO:tE w~w( . ;ac ~a~[-- - - - WT[ ~i DEl7~+ w•~~_ ~i~~ tiS~l1 ~ , ~ ~ ~L~.} TtCJI~~QJRRAC[15 @ik'.. A~,...._..... ic .~7<ncc.-__ ~_~„~'_2."~71.'1 ~ Z.~C"~; j f " AoE '?~~.w• wCt• •~•~_rVr. ~r.T 1 ~ j ~~:.1 ~:a._ - . . :~..e ~ z ~ ~1~ - l --~--~4i'_nt ~ ~'~ce~~ - ~ C 1'~r ~4~,Z _~7 - .•t ; E. ~ ~ • ~avE ~tiG P v;ti~ ~ . ' . - _ - - - - . ~.c ~t'-ih' ~9 ~i~._41~uE A'.D @`C'4~.1~:t vr v~.:S.:rq R, 1`.,`. • ~ ~ ;`a„ r•:it_~o . .ker -_i:~:ssia Sarah ~;rnha•.:m - ~~issia Is~~ ~iTiii~ J~ M'4AT CO: \'r• ?f 50.~~~ GEi~~ h~',3Ec r ro .i.tr .a~~.~r •~x,•fn ;3 M1ANE Cf SUR~;~~'aG S~JU;e .s •..a t~rt~ r~~[~ ~u ~ ~li. S. 5G~_E~-77?> i:-~ s.;::., r rrie~ IdeClaire ~a; e.t •Y~ _ i~l .45' :CC:P~T::h ~ ~e ;wi iaar•E•'~i`~.~S:C.~a~?r J4s~+y R K1NO0~ ihDUSTf~ JR 5~$\c.~-- • u.~ ~ _.u _ '~'edic~:] Pnc:~r SPlf e,~~?ot~e~ I ,~edicir.e o:~:F tF i:iATh---~a~E c~ .a y-ta .•,•a•.:~, .a-. • 'iB~ =T±~f1 Ai,~qE55-~s*~tc•a~, , ~ i e[• ~:x~~ti~.. P~ , r• :,~?.n••~ a , . ~•E. .a` E ; .'n5•- VdIIE': i:C`"'.... ~ t:0: ~7'_~al ; ~33? `d?~Od ~ 1V~. ~ _ , - ~ • - - - - ' ,~I.. ~a' . vti ~CN\ ~~iBE C.^.~i.h' T.~r .vs• . --'~S, . _ . ..a _ ~ F~ r~"•~ i Los A-;veles i 9 9 j'9. .iiu~l RfS::iE~t--StR[E' +A^iIEA svtt* u: ~tr~t~ ~;ot~•~r• ~19~ :AS•.'~f Oir =pllapR~i[ ~~~1iR IO NiYE AhD MAiUhG ~DvSE55 OF thFORMAI/~ ~ ~ ~ ~ ~rc:s, ~rs w ro~ =£S.CE ' c,e4~ Co?bath ; Yes IdeClaire Ar:ker x_....~: ~ -.•,.a. r-~_ c ~r T~wh---- ~t9r ~o~~,,• - - ~~9~ sT~,c 4445 Col.bath - - - ~:-;tac~ st•.+e ~ _ ~ S'-er-_r~~ ^a:cs : I~os A.^Qeles ~ Califo a Sherman Oa'~cs, Catifplrnia ~i'. : ~4^vYfR1 -~.~r ru•.. ..v :2:~ ~MTSrCiAk ~ r.u• «<...w . r~.ee ~ ~ r.•.>:,e...e. ~ •v w a.•~ w~..:a +•.•~e .w.~ 2k 11M OA rr.y~.cR- MYtMt Y~ MWt ~ Z~ CATE SIGhED , ~ r • ~ S \ ~ . - .c.. ...v , ..w ..a r..u w.~. w .•.~..o ~:nw , ~ ~ . - , f / i.. tis~'•'e:~..cy..~n.•....~-~.~_ r~7r ~ •~D • f ~'tt"~ ' ? f ~ I .1 : ~ 1 , -."1f~ ~~r: C ~ y c.:us~i r a:.-+~~ r ~w ~ ~r~~.~.~. x.• a.~ ~•1•.~.• J . _ . i~•: A' ~'V ~ ~ ~.~i~ 't`'~1~.~ 2N-~ADORESS • -i~j~ ~ ~•r-.~~c.u•ai.~ ' ~ , ~ = . . } / ~ ~ t~ j.. ~av-~r .aa:.3.~ i /r~ 4 "•i,• ~ .~I • 1 ~l. , ' ~ I j ` / 7 '27~ s~c_.~• a.... [+n~.~.c.• '21• DATE 2l VAYE OF CE1[~TER~ OR CREilATpR~ 21 (KSALl1E11-S~~r;;as ~EMZ !Wt ~ - .•~E~''.A_ I~ i~- 1 ..A~~' : : • ~ - ~ :.:t.~ :~•`.arcr 3 1° 9 E'~~^ "t^mc~ri ~1 Park , ~.~-~u~.~ CJt..,..~.. F ~ ! a_ ~.S e~~_ ^ r..+.Fo~: D~RC:'_= Ca~[~s~rr~v?ss./ir~ 26 ••=-.n.--~ •.s ~ sa ..~..:n'n.e~n~.o . ~ - l0_Al REGISiAIIR- S~.:v;uAE .,.1,.,,~ _ ~ ~ ~'K.~. ~l5 Y ~ , ~ . . . ' ` ~ ~ ~ ~ ~ ~A~i~/~ ~ • ~j Q Q O ~roTa.~ der c~r~uhr~~ _12? - GF~?~ olf C4.SE0 ~ CstE1 G\L• G~E U_SE ?EA 4vE i0R ~~0 [ ~ y~~- ! i iYYE~.~'E ;~.5[ ~ 7 / ~ { ~ ~A ~ /~Q. J . - . . . , • ~ , i y~,,: i • ~ : ~ w~ `~~.;E . ~ U ~ :JaSEG:ME Cr ~ ~ M ~ E . ' ~ ~ o~.=p : ~f ~vv[^ 1 B, ^ ~ _ . - . ' / ' ' / . ' . , ~ET ` ~ •-f '~,S[ S*~-.vs - ~ • ' ~ I t• ~ `r ~ ~^.:E 'O ~=4 a :JKEO_EV'E C.s ~ ~ _ .:4~" ; "L -~:f=. C~vS~ ~ ' ,aee r _ ~3y ~`L~_ I~. ~~MEF S'~~_•_i~(- CJ\;':~L~.i:__ a~.'~L~:M~•~~.'~.'.~~.~-[ .,~~.'~.'L~~~.r[ - C •c~ 3! . 3ta 'r«' ~ ~ . MY~'•-~ ~ Y1.• ~ > ~ . ~ .f ~ . ,t~1 • ~n~' i ~ ~ 3 , , 1• , / l • ~ • • ~ c:t_c. a...~• S_.~_i:a6~:nT 3a R~_lOS~?)..~r,s~.- •~u.a•. ~ . F... ~ r.s~.;. r: a~••. ~ 33 i~~:1R'I ~t Yrp1a 3oa 4~ E~ Vr1J~r-- ~ ~,;e! wR ~ 1 .._....,a.~ - - - ~ ' !ti)L~G. ! '-o_~:E'~c s'~.f'~r_~_...~2 :D:NSa~~::...J~'iw• ,j7~ cr~.c~na...a~;~ 39 .n~..~r.-o~.'~v,>~.i•-w:... ( .•v..~..-v.~o . +w~ n.._ . ..:r...~ vu -~e 39 x.~ ..o...c--o. •iK\l :•t~l y~:u.wy• ' ~ ~ ~lR~1A?i~~'. ! , ~ ~ ~ sits ~ 'tC ~fS,a aE '~M a~..~. .,~~E: r.•r. ua ~.a v ~.n•, - ...1. ~ _ . , . _ - ~f„,._~e~.~u_= +nt~~ ~ ~ ~ " - ~~~TE ~B ~C D E F • ~ K. ~ ~4~~~ ~ .i ~ f1LE0 As~ ~ECQROEO ~ ST Li1CIC COtlM~Y ftA. F:." . . ~iTRRS ~ _ _ ~ _ " ~.~1T CCURT ~i' - - - ~ . ' 'C^i'iCD~ T~:T it ~ !~c~, i ^~z, f.~~.;V'v~'• *M~ SQ';:~+fi•^ i . ~-E Rt,.2~eS• .s+)•. ,~Cf..ir~ 'Eft.r- y~ fE8 ZZ I 41 PH'~I '_~'s~ . ~ ali.~Y *~.f-~[~~_ ,b:-~'~~~~i~. _ M~;f . ~ ~ - r'` 1 r T . _ : rxJ i:,~ ` s~=1,'- . ~ ~ i ~ ~~i ~ • ~ ` 1 ! S'~ ~ ~ i~-;. ~ ; . r,.~`I.,F~a+~/~- rc':~=If~N.~ ; MIC1tOFILIJ MEMO ~},"~'~'~~.~~ll~~..3ti~:~r:.'^..:,~3:~a.:i'3~~::lt:.~ i,egibfiicy of Wricing, typing or printing u~satisfactory in ~ :his doc~nt for microfilming. Y~y ~ p ~~7 ~ e~~~~K r' ~ ; ~ • " - . ~ ~ ~ au ' ~ ~ r ~ . md~~~n?~:~~^ ~ ~x~.,_..~~''-,'.'. . . . x :~xW