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HomeMy WebLinkAbout1088 . '-Y.~ _ ~9469 ' CEl4TlF1~4T~ AF C~EATH pep~.a,~ Ik.t~L .d ReL~L11N.M.~e Savks. s~rwn nu Na av~voFr~?~TM FLORIDA TY?E, O! ranr ~N ~ro~srewR•s No. 136 ' /itMANtNT INK ~_N~ ua~ SEi DAIE Of OEAM ~•oM++. w*, nu~ SEE NINI00[ F0~ tffdKTlOIS ~ H 1 ' fwCE wn. wow. ~reuuu. wwM. wGE-uft wa~ ~ n.~ wa~ ~ wr OATE Of NlIM ~.a~r. M~. COIlNIY Of OEATM nc_ . wcr+~ wnr.• ~ nui~ .ws. oa~y .ows ,u~ nu ~ 660 . White 80 k .~Tov. 3 1890 Saint Lucie , Glr. i0'w?1 Ol l iWN Of DEwiN rsre cn ures MOS?RAl OR OTMEt NS - ~r rw r~ ewy~, aw stia w wwra ~ sncur ns o~ w Fort Pierce Yes Fort Pierce Memorial Hos ital ; STATE Of MtlM ~ r Mo~ w~.s.a.. Mare OTIZfN Of YnNT COUNTRY MAt~1EO.1~EwEt MAR~EO. SI'OUSE ~r v~w. Nw r~ww w~e ~ „„a„~ , Michigan , U6A N"0°~fa~r France.s Law r¦eu ~euw~e~ SOCUt SECW11f MMMEt USIlAI OCCY~ATION ~un ~w o~ wo~ ~oMe wMw .oa w R~ID Oi MlSNESt OR rO1R1R+f ures. r~enr aio~ao ++ai. m~ a xn~e~ ~ « ~ o~• Mechanic - wutomobi ie ,~.364-36-9388 ~L. s..~, •o"'s~- ~ESIDENCE-SiATE COIIlITr GTr. iOWH, Ot IOCAifON Florida St . Lucie Fort Pierce n~o"' 909 Flood Road IN. IA. 14. IW. iM. fAiMER-li4ME ~rst ~rat uw r+~0i11ER-MAIOEN NAME ra~t r~Ne uN : , „ Joseph Seibert Franc.es Wida • I WORMANT-NAME MAl4Ki ADD~ESS ~fnlt~ p~.~~. MO.. M O~ q~~. Y?w. y~1 ' Mrs. H. F. Seibert ,,,909 Flood Road Ft. Pierce Fla. 33450 r~ur otwm wws cws[o ~r: ~~rcR orar or,~ uusE r~ u+[ ~ h~ A1~ aro k!I .m.uM sown .,r w~+w . ~ _ ~ • l~ifil.Pi~ coM~mows. n ~~n, • ~ ~ ~~4~ trw~(w O~~t t~tt p~ hl ~r~~M~it C~YSI 101. A~~~ a: f~AhMO iM! •M~(t lfeM~ C~11f~ Wl IAIT A. OTNEL S~~~KANT C~TIONS: Cby1710Nf COWY{Yf~wfi p Ol~M Wt MOt YM~ti 70 4YY G~11lM M IY1 ~ Iq ~~asr If ~ES O~~! NMNMOf ~OM- ~ns o~.w, f~re.e~ r Kn..wwo e.u~a a w*¦ w. tw. MOwC~04 Ol IRO~tEMI/~1[O ~~OA~w. Y~, ~e~~ ~ MOW IHl{Itr OCCYflED ~ bwe~ w~~ p rwv eM ~ur ~ p r~a M. wr u~ ~ 11c. M. !U. INAtRr Ai WORIC ~IACE Of NJUtT Mo..e. ~ur, snen. ~.owr, IOCATION . ~ Wen O~ «o., an o~ tO+r. 9~ i ~vean ns o~ ¦o~ owKe wo..nc ~arecwn~ 7~ 1M- ~ ' CHtIFKwTqN- .o.w. .uu .we. ~n. rw ..r~ r~ r wd.e~ u~w ioii~u~ii.a~ M~woTM~~~~ kw w w~iie~ieu ~M~sKw+: Tp a ~t ~or.e. we ~ .ncnK~ ~we ~ ~o ~w ewsaa~ sun~. ~u.u...o. -~Y-7~ -~f-7 3 - - :w. ~w~i~I CERi~1Gi~ON-~EGK~?t Elt~?rRaER Ot CORO?~El: a. w~.s~s d oa wo~ a x.a Twe ~ecne.a ~n no.owaa~ ew lLrrutiOw M 11! W~~ ~M/O~ A! MIIlf*IOa11pM. w~ rf qM~O~~. rOM~M Mi / F!Y w~00j~ OlwM OC.CY~ Oia M M! MO N! b 1! 4v1tW fi~4~. ^ ~ ~ ' / If ~ Al' ~ ~ M 77~. CE1tflF~ER-r~,~ME crrrt w?wn S~vA ~een w mu 51GNEO ~ra.r. 8usseZl L. Counts, M. D: ~ ~ - a~ .n,. „ a .b. ~m ~ ~ • ~ WMAI, GfMI?110H, ~EMOYAI Rlf OR CtfMATOtY-NM~E lOG?t10N 4n w+e ~ petrr ~ ,r. Crema?tion ,N_ Ft . Pi erce Crematori a~ Fort Pi erce Florida , OATE ~ . r~ nu~ Wt+EIULL MWrE-ruiwE ~wD ~DDeESS ~ s~un oa uo.. cm w w..., sun ea ~ „~March ~971 ~Yates Funeral Home, Box 7~7, Ft. ~ierce, Fla. 33450 v. s. i61? f e~s s,eeun~ o~ acm~ ww .cauw R~v.1970 ~ t~.. ~ 1 1 971 w i hereby osrtify tha to bs a trw and ootrect oopy af tfis Loul . Repiqrart reoord on ~le in th~ St. lucie County Heshh D~peA~- x. rr~f at Fort Piau, Flo~da. ftLED ANC RECOAOEO ' ' ` ~ = • ~~Ej - ~ , ST. LUCIE COUNTY FIA. t . ~ : . . (W~rning: Not va~id unless raited ssal of the St. Luci~ ROGE~ P~~TiUS ~~~si~ r;i+' _ ~ . ; „ • 3~ r'-> County Heslth Oepertmsn? is affixed.) C1ERK C~ .~tlIT COt1~tT . ~ . oECCP^ VE"'Ft£0......~.,.r. t ' , _ . - -L N. D. MILLER, IM. D. ~,5 il 4~ i 11 ~I~r . '-•s%' ~ County M~alih Officer 3 LAUI Rqittn~ ' ~ _ _ ~ ^ ' . . . ~ :i ~ 0~ D~P~+tY Loai Reoistnr ~ i;~~'~i: . ~~9 • _ w ~ • ~ " e0 K20z ~cf1088 . - . ~ _.i _ . ' _