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Home My WebLink About1886 n~EO aECuaoEO 2S94~ ST.luc~c couNtr f~A. ROCEk POtTp1S Clf RK „I'~CtJ~T COURt pfC~R~ ~~.•^.?FtEO_.r.~..,.,,, Ju~ 20 I 4o PM'13 2594~~ . i in~: Oe- 6TATE aowao or M~?..n~ CERTfF1CATE Of~ Lt~,,,_ r? ~ cuaes • aURi/lU 01 YITAL rYATIQTIG~ iCTATi FIL~ TiO. ~ ~~s~~ r~~- FLORIDA REG~~qAR'S no. 2b ord ~pen BIRTH NO. ~ proptrlr cooe NO. 2• YiWI R[NO~Mii!/~~r~wrA~/ f!wanr.w~ A~..M.«br.Ww:~ ei~tut~d 1. ?41C~ OF Y[ATN ~ STATE e. ~MTY •nd •fll e• ~1~t~0 • r. K AFS~DCUCE ~ A. CITII. TOMN.OiI lOC4T~ON t. iS ~IACE 0~ DEA N t. CIT11. TOWN.011 tAt/1T~GM INSIpE dTV IIMIT51 le P~f- INSIOE CITY lIMI75l a~n~at YES MO? YES rW ~ l11~. I. ?t~t~E OF Nt iR Mi+~itd. Iirt uttd ~/bta~) ~ 1. ST1tEtT ADOIIESS ~ Mp5?ITAL OA INSTIT~TqI! ~ 3. uwMC or i~.x Viaes t,.u 1. o.T[ M..r~ D.r ~ia. O[C[AKY ~n~ M~~~~ GE,~IE THON.AS CLASBY °E"T" June 1 bb S. SEx ~ CO:W1 O~1 1~'E 7. MANRKO ?~r YfA MARA~ED ~~TE OF b11TM !~6[ (I~ ~tY1 ~~?.ocR 1~W ~p.OFa tt WK. JC~ laM sirNl~!) X..u. D.y. Bwn ll... : i e• jl W reaowco e7 avaaeco Au . 8 1 18 y1~1~1p l0~. USU~IOCCW~T~ICitetiRl~/sMtNu t~.KMOOF~US~MESSOR~NDUSTtY 11. WRTIt/U1CE(Sl~ttM/NM~~'N~W/1 12.dTtL010~ww1TOQY~il1/ • i tA y~r- ~a.i~~ ~wt y ra?ti,~~ h/r. neR iJrKUdI ••p•p~ Accountant Construction Warren Co. Kentuc USA ~l~Ct lwk 13. iATNER'S IIAME 1~. MO7ME71'S MAIDGi NAMF ~s.•~~1t•• Jame's C2asb Lillie Robinson K. SOCULL SECUR~TY IA. 17. INtO s s~c~u?TUwc w+~'~~ 1142 Binney Drive 402-05-523 t~"rs. Gene T, Ft. Pierce Fla. Punl?~1 1~. CJ1YK 01 O[ATN (FJllt~ a~l/ ~~t Nws 0(? (~~t Jr 1~1. 101. ~R~ ~t .j I~tTCirVAL D.~TMIEfN ~,~t,pT,~p ` 2~~Utl S TN dir~tt0! ~A~1TL OEATNWASCAYS[O~Y: OC•cL.~i•~ lill~CYlOI1 ~ ¦ u~ t f 1 I• . IKM[OIAT[ CAUSC t\• titie~s• C~~litiw.iJqt. puE TO (6) ~Ste tl• u4id /os ru~ t~ ~ . 1 o t'w 1 ~Datt cswr (i1. re latr~~ +~w~1 t1e rw4r- ` R I~iRI C~aK 1u1. ~4E TO (d fltAln T2 = ~ . WASAUTO?SY Aou~ i•~- O rMT 11. OT~ SKNi1WT COMWTqKS COp1bMJfWG 10 OGTM ~tff NOi R[UT[D 10 Tw[ 1GMYMl 015fA5[ CWOIT~ON GNU1 W?Yt 1(~{ ~ppORMF~O(t t~~ d~?t4 YES? NO!^J 3 oe' 4~for• IRM~ 1 ~,~p p[KR{~E NOW tN1:l~lrOCC~NREO. (Eal07~dYIt 1/IIUY/~ 1; PW /M PYf II N~t~ 11.) ¦~klab ~p7 ~ ACC10(11T wK~a MOYICIOE •~~pest- v ? ? ? ' ~/1 Ot J mc TtME OF /Ienr Afw/?, Ml. )'tu •01~. v 1lUUPY a. ~ ~ A. ~ 2W. W1UR1I OCCURR[O 7Dr. ?IACE Of ~ruuar tr. i. a.~wr b.K, mf. ~m. TOwM. OR IOCATION zO1JNTY 57ATE WM~I[ AT ~ NOT MfMKC ~ k~w. H[tat. aurtt. sDi[~ OfN•. [tt.) ~ YYpMK AT lYO1lK 2t. ! ~ft~nd~d fM d~ews~d /rom ~a.~.Q.z~. ~o _ ~7.~ib ~nd /ue s~? Ai~ ~ln~on ~~bJ ' D~~tA oceurr~al ~t m on tJ~~ d~t~ at~t~d ~bor~: ~nd to th~ 6ut o/ ml k+b'/~N. lrom tA~ uus~a ~~~te0. f > ~ NCNATV~[ ((MOret M fitk) 2?b ADO~ESS ?2t. OATE 516N[O y •r• to D• ~ ~a.,~.~. • • ~ ' e e a 1 -66 •et~t~t~. UEM~inM, jb pnTE 27c. ~u~EOPCEMETERYOnCRCMATOA~ 23/. LOCATqN(Clf/,fNO~.Nt~waf/I l~~~~ AEr011A1 (Sytl~J~i ' e e Boxlin Green Kentuc ~ , V. S. ~ 012 j~. iti~'KKRAI O~MEC~Ow S SIGK~TYRE~~' y~~~h . ~.t . 2S. pA7E NFC0. iY LOCAL 14E6. ~GKTRAN'S SKMATYRE ' ~ ~ 7V l~ , a~..1966 p• g~,rd Ft. Fierce Fla. 6-20-66 Mna Lee Denison d.r. , t r ' t ; ~ I ~ . . ~ ~ 1 haieby oortify thls to be a hw end aorrod ; oopy af ttw Loo~! I Rogistrars reoord on file In tho St. Cutb Gwnty Kcahl~ p~ _ ~ ~ mcrrt at fort Pieroe. Fbrlde. ~ ~ , [ (1Naming: Not vaiid tmless nisod saal of tho Luc,10 ,~~L ~ : t ~ County H°'°hh Deps~tr'nen! ts afRxc~,) ti~' - ~ C~ S•~ , ; ! N. D. MlLL~, ll~l 0. ' ~ _ ~ " _ T Gota~r HaJth Off~acs i Loc~J ~trar y~ _ ! - ~ '`y?,; ~ ~ ^r1~ ~ . ' ~ ; ~ ~ ~ i i i ~ ~ ~ , z t , ~ ~ E ~ . ~ ~~zis ~1~~~ ~ _ _ ; _ : ~ _ _ ~f ~ : _ : ~ ~ ~ _ . . _ _r_~ , ~ F_: