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MICHAEL (MIKE) GASPAR f
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RE: Lot 26 and the N 1/2 of Lot 27, Block 2, AMY ANNA PARK {
SUBDIVTSION, according to the Plat thereof on file in Plat ~
Book 4, page 72, of the public records of St. Lucie County, ~
Florida.
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I, Merlyn D. Vander Broek, Clerk of the Dis~ict Court of said County and Keeper
of the Records aad Files pertaiaing to said office,
`~bo G~eah~jc l~iot in Death Record No. 5__ _ on page G-11__
of the Official Death ftecords of Sioux County, Iow~~ is found and appears the fol- ~
lowin~; Death Record, to-wit:
Michael Mike Gas ar ~ -
~ Name of Deceased ~ 4------------------------------------
Age at time of Death ~-S--y@ez'S ~
~
~ Sex ~18 Color ~'!n?ite___ Single, married or widowed Sin~Ze__ ~
~ June 1, 1968
~ Date of Death
c~ Place of Burial St. _Mery' s Cem. ~ Alton, Iowa
~ Place of Death ~e~e_ City __________~n Sioux County, Iowa
Ventricular Fibrillation
Cause of Death
~ C. B. Mur h
Physician signing Death Ceriificate
' ~ Undertaker in charge __________________A._ D.__V~tt EtteII
- - -
'j ~ ~ June 6, 1968 ~
~ ~ Date of filing Death Certificate
E ~ as the same appea~s of record in my office. ~
~ ~ . ~
` - • ' .
~ IN WITNESS WHEREOF I have hereunto subscribed ~
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~ ~ : -.~r~~'~;i - m3• name and affixed the Seal of said District Court
~ c~ `s~r . at m office in Or e Cit , in Sioux Count Iowa, ~
: ~ ~ . _ Y an$ Y Y, ~
; _~r _f$~~+) W ; this 318t day of July__-------- 19 73
F ' • , :.s~s f
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y ~ ,``~li:`'`;~ ~ . Clerk of the District Court.
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; ~ (Fce for Death Cettificate 52.00) BY Deputy ~
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i NEIIL ORIIFIN J!F?q1ES i LLOYO ~
CMARTERED
P. O- S07c 1270, ~ORT VIERCE, fiORIDA 33~E0 - TEIEPHONE (305) 46~-6200
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