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Home My WebLink About2419 < , , . . . . ~ PASCO COUNTY ~ALTN DEPART[~NT ~ O d 8 O O t CERTIFICATE ut utw ~ h I 11.•.~111~ rm1 {t.l.wl~llibH~e ~.vk'!~ fTATE fil[ NO._ - fI.OAIDA ' „~.~.~,.~w irrE, /flNi IN `~~•"VYO""`~~• pEG16TRAR'S NO ' OECf~SlD ~+~~~t ~~n~ rrowe ~~t~ SEx OAI( Oi OtATH , ~~+'~~r, o.~, •f~~ • - ~ Ii~M~NtNT INK i uc ?~~owoc ra ~ ~M~~~~t~~o.s , CHEST~R A_ ~ ' R~Cf •.o:.... AGE-i•v u.wn ~ n.f w~w~ ~ o.~ OAfE OI ~~RM ~rJnrw, 0~~. !COUNTr OE DF/~i!~ # erc ~.eur. ~ ~,u+a.. ~ve~H~ rOf. wri rou¦s •ue~ ~ ~l';!ti~i' s. ~2 s? ~ ~ ~ C~TY IOwrr Ow lG: ~('O~+ OF DEAiN vsro~ u~+ iwua HOShTAI OR OTnE! NSiRUI -?+~E w~ ~~'~e• vn~• ~~wt~ sn. .ts O~ rw - ~ Nit~~ Pi~ ~ t~~d~e1 5~~5 T~ GlebZ Pa.dco Ho~5~1•~,taf 31Atf O+ L~t~H ,...r ~ v>.,~••~ GTIZEN Of Wnwl COVNTRY MwItRtEO. ttEwER MARbED. SU~WVwG SPOtlSE ~~r ..ne c~.e a.~ .•.re • c:w..•~. ~ ( vJ WED. t11V0 CED ~ vttrr ~ I ;,~v.~ ~ua..a • ~ ~Vill' J~ ~ } C USA I~ctttJt,c.ec~ _L A?trta E. E4C~C•S{i C',U„ _ ~•~~e o~:~.aeo 5~~,~1 SfCUR~h NUMSER ~ ~USUAI OCCUfAiION ,c,+i n+o o~ ~~aa op.t ouu~+o rosf p KtND Oi WSMtfSi O[ INOUSI~r ~..f~ +r Df~tw G~a~w6 ~~~1. lYtM 11 Nt ~fL 1 ~;~'..~~fD ~r~ ~ ~ a _ ~ ~.~evaton I rtb ecton I ?tib tvicance Co . ~„o.~ 1 S-,- t 'F A _ _ _L-_ - - - - ._~.~ss~c~ RE~~Pf~+:E -S!a't jCOUN1Y _1-rClit, IOWN. OR tOCAIION ws~w tm ~~,.~n SI~FET AND NVN~E~ y ~ ~ s•eun .es o~ ..o ~ / ~li'':(Cf~i ~u PQSCq ~k ~O~.LiILf NO u. 136 Sa~cr~~ D~uve ro t~t~~FP ~.a~.F r:~i~ +~OGe USI MWTMER-ASA~DFN NAME ~~~5~ r:0 e ut* ~ „ Hcthni~ B-7otVrt u Not li~atieu~tn_ INfURM~NT -~:~.!F AM!fW(, ADGRESS ~sne~r o~ o wo. u*• o~ a~.-e t~•: ,,.!.tn,s. E. 6no~u?i ~~n 136 Sct,~em ~h,i.ve N~~.~i.dcu ~~o-~,i.da 335k9 ~ •~~\J~~Y tM (~~V FARi ~ GE~iH w~S UUSED ~`I~ (ENiER li+`tY ONt UUSE ?Et tWE f0~ fc::, (b), A?~O rr~; ~~f1~IM a~s[T ~n0 ^.l~t~ k - f _ _ . _ 11 ~•+r+~~•te C•use ~ 1~1 4y{~~~~_a+.~3~. L.~'~ CU/ ~L~U~ `VlNJY~~n1 f ~ „ 4 ? ~ : ~ ~ - - - t - - . . _ _ .r. ~ ; , . ! ~ ~ • hJ~. uf~ ~ i ~ct ~ _ . _ ~ t ~ ?A~~ 11 (1'~IF~ 1l..~i~1K Al~f.il~NL~ILlIH'IS GaMpt~O'~) (~~Nt~1~~I~.~C. f1 O~~M ~i~I .~JI ~Ii~110 IO C~Lr1! ~.~AM r~~e n rAl~1(~St ( ?~S ~1~f ~~r~~wGt (l~M 4 ~ . ' _ ~Il :i1 - ?~Ct/~': .w L~i~~~.~.~w'. C~YI• f I 't ' G~ ol.~w !Iti ly(1 ~ IA ~ . . ~ ~s.~laN~l A , ~Pt•.s u'a ~Si! OR ~6~T~ n1 (NtU~~- ~r~:aiw. O~r, ~1~~~ Ft~ IM~W IN1U~1! VCCUPR[D ~ ~••q~ ~~o . •.r ~ ~.~r ~ ~h fA:a•:._~Rt. , f.V r.:{~ 1 ~ . ~ - _ ~a M ?~a INIUtY Ai vt~?~:~ ~?iwC! !`i iNIli4Y .o~e. r•~. ~~nu, r.e: lOU[WN ~~n1e+ o~ ~ r o or. o~ ~o~+. ~ ~ s.e:~n .~s , . ~ •~u ~.o:, . rc ~ sno.. ~ ~ * ( (SRiIiKAT~C4-. L`~• ?l~~ xOMM O~• lt~t aN0 411 y~v+ ww:~M[~ ~1~~f W'~ ' O~D! D~+'J' +~I+ •^I~ O!~"N OCCUI~ID ?t INf I;I1CE. b'~ 1~1( IN111CI~N tO i +OY~N Qa• •l~f •"1~ D!.!w ~ . pa~l. ~~A. ^O ~M ~fl~ 1~^f~_tC ~ I CI rt lrQ'~LLOG, YY! ]l~ Ol:f.~ea V ~Q ~21? C_ _-~----i-O 7h O ,71t __L~ ~O ~ M to n.t U.sr Sr SLqo CE~i1f.Uh ~r. vED -~~t E~~wuNER OQ CO ~,'~ER o« r»; .•+•s ~w[ ~.ow o~ et.*~ ~ME DKe e»~ w+ re;r.a ~.:fD :I~D l~~r.M.~ ~ .pL iwf .!t•~ ' .w..~ ~ rOe~in D~. •S~~ M.~• o~.~~ oe +..e: ~ . ~.n ...r ove ,o :•oa~ ~~r.i~,o... ^7 D. )h , _ M rn - - 4 - ~ - - M CEY(UiEa- r~~v! ~.e - _ - - S~y~ K -..e~ o~ , G~'E 5~~:.?~+EO ..c.+n. w., .w~ G. " G~i~t?i2ra1~ ti1. • . - ----~:ti -~Uo_v. 9~ 1970 k~~UNG wDt~QtSS • ; tr~u~er - - - - - ~ y~ ~ r.o cm o+ w-.. v.•e i.. bl4 ("1tu.v New Pon,t P.,i.cJ~e~ ('orr,cda 33552 llNl~l CREMAII. fN UFMJ'~A1 CEMEItRY Qit :Rt.y1AIURY-NAMf I~CATION O~ ~>w. ~ sru ~r. ~ Gu~ c ct~ P.~eat~oa+e~~t~?t _ r.le?nu.'c.i.aQ GdrUS New Pon.t R.i.cl~ec~, Fx'_e•~,i.da ~ ~~Tt n.r FUNEAAI MCiAf - N4wE .tNO ADOt~ S: 1 R~UT O~ O i+0 . C•tr 4~ tOw.. V~1~ J~~ ~ i y~' ' ~•naC Hus~t.^~ 5401 U. S. f~~'~ 14 ti~n. HoC.iclr~r~ F~.a. 335~y N~''t~ 1 s, N0.'t.#~t Frr?., f~ Y. 5.~61? ! ~~~s ~Sr - E .e~.t51MR , .al;.CE lo~~t ~~~e~.ec ~GC. . a. S'~~~ ~ R r r. 141 i, 1~~ ..t 7M - f~ if ' 7~s ~ ~ ~ ~ ~ _ - - ; - . - - ~ ~ " ~ ~ ~ ' .u... • ~'r l i' T}:~ ~il"~' ~ ~ i 'F ~ ~~..i l~yj/. :~i'.~ . - - A ~1~ ~r ~ •~``~Lt~Q~~C~~~'%'~'' ~ 'w ~ . J:fi=`~' • }~RFBY CERTTFY THE AB!~~ 1'' ~ P,E f1 TR~`r .~\D ~(IP,RFCT C(lP~' nF Ti1E ~~e~~~ r 0.'~ir.: -:V ~ ~ L, R~'(; I~T!itaR' S R~C(1RD F I'."r, I': THI' !'A~('(~ C~~lRdTl' itEAL'C}1 ^~"j ' O :i 4~~ ~ ~ Av . v~`~ i~; •Y:,i~A~t'f~1~:tiT AT t?AnF CITY, FT.+~R~DA ~';~rnin¢~ Not valtd unle~s ~,~o O , . . _<~-lt+t~',;-~'~~"'~~~sfd Seat ,~f the Yasco ('o~int_y H~ tr;~ I~ep:~rtme~j i~ .~ffix~:l.l ~ ~ ~~~:,'t;~.Y "a~•Jti ~ / ; ! ~ A~~ ~ ~ • p,s,.. • ~ ~ J ~ s f ~ ~ ~ ' _ r'-l , ! k1/ ; ' ' / h~ j ~ ~ i;~ ~~y~• / • .___-_1 , r , '1F'~~ ---r-~ ~ ('~*.~nf 11~.~? tl~ ~f f i cer'a~xi 1,~c<~1 Re~istrar ~ ~ / ~ ~ ~t 1,,~ c e - '3 - - - ~D u I.ocal gist r - ' ~ ~ d~190 24i5 - ryY ~:_v ~ _ _ . . . Y .