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HomeMy WebLinkAbout2495 • 1f . - ~ 1 + ~ • . _ . ~ ~ . T . ~ . ~ ii.a' i : _ _ , ~ . ~64~,~ ~ t;-GE ~~Tt vF rt~tt~t•:.~r~ v:.>>-:- _ _ - - - - c~` ~•nEDfC~~: :.Ef:TIFtCATE Q~ DEt~~?-+ , - - . . ~C „uefc ~ ~ ~'~'~_i. ?J~~~~~ _ ' . . ~ . . - .t .-.-cr!...__ . . . ~ V1'~~. ~ ' l r w ! " ' ~ , T Q~1 7 a ` ! . 1 ~ ~A~ t 1 ~ - YQ ~wi~?~ • . ~Ll'v ~ _ - ` - - _ Bruce ~ -F~ -~a8~ T~..,.s:,~P , . - _ _ C•~ . . _ . . ' . ' ~ i , . . . -t?~.Y`i ~c ifr..}*.. _'t*~CE ~ ~treator j days arand Ri~ - j~. , ; - - - - - - . ...:.t: _ . . . _ _ - .-:.:Et; _ a.d~.:.,,-o+:ss.do - " , v~ : . . ~ l ~ ~,.v.~ - - ' S~e.~ ~tt',?~ s. AoBp. 's dB,Ts _ _ ~ ~rs C_ _w~ ~ , ~ . '~l:.lnt : ~ . . . . . _ . _ . . . ~J.:e~ ~~Ewd ` f•'.,V Don 4r~thur Roil ins geb. 12. 1961 > - - - - _ _ ~ - - - - - - • If' v- ~6 +cF.ll . . ~ . t.. . . ';-,h~lse. ~+RiQ ~JiiY~ ? ' 1' - ~ . ~ J 5 . ~iS~ !r• . _ ~a~r~ea Cet. - `~=~9 -~1 9~ ~ ' ~ ~;_o .-:a: cur,,-.,_-;-~ . • • . . . . . .,-..;ar: t.•- - . a- , . . ~ ~#ei~ol~i,ant' Cornell, Illinois . ~ t3 fAt'~Fw S FUit ~ . . . - - - . ~ ~ ~laraE . . . . - ~ 3 weelo~? P. Rinker ~ - _ Lura Eoti+ere : T; ~ ~~%G! ~:~:~OiVd @.Ci ~n j/ [ - . . : , ' . _ . % :1 C " 'il~•i . • y' ~ ` . . ~ . ' `,':l,:". L . ' . ~ 3 Zee l~rorld w~r 1&2 343_1~0204 _ --~~oel ~ollin~ ~ ~ ~ _ ~.~C~ _ - - ~ ~«,ar,ous...~ ro ~ . ~ ~iB LAUSEOfGEATM - C~'PF1Tt~ ~al~t~~ ~1• w3t~ Q ~ ~ rAiT , L;ATH w.a~ r• . _ - • - - - - - - s~ _ . . `i ~EQ AM~RECQr ~~~i[Q.~~ BErwfEN ~ ` ~ =~.t,vc~F o~t~~ a IONSfT wN0 OfATH ~ ~ It06ER POIfII~f ~ ' ~ _ ti:N'Ei.~A1E C~..~:c ?~yooar~ial ir~arct ~ ; . . . CLERK C~3CU1T p0{~RT _ ~ ?~i ~ ; ; ; Cv;o.~F,~.f_ .f o~, . . . RECORC YEP.1fiED ; - --l~~.A.cs9e~~--<k~ ~ ---:40IItB $2'01'101'1~8~ -~~~~'1~t~ ---j ~-1AAt~-- ~ - 'tO rr~c5:..a:vtan~ zr• t 1 3 ; ~ ~ F C.:uSE :.i s ~ . _ . . - i2 r~-PM- ~3 : ; 'E thavivJf~ir•rv~ _ ~ , ; s :~:,Q,,,, ~ _ Pulmonary ~yhRpula ' K mont2s/ s i . ` QT~•tK^~'. _ " - - _ _ o . _ - . :D ~O "fE ~ER'A~'tisi ~OND -.;~N v tiEN .N F%.8i .W ~ ~ ~ i 1~,Wj ~ ~~~0~ :19 ~l11~Sy? ~ ' ~ - - ~ ! . a ~ I e ES ? rv0 ~ ~ ~ ~ Q 2Q CES_~ 9E C'RCV• _'~~~tc , _ '~;U•• . - _ . . . .."1r ..T~Ei . ~?ii vr'ri It ?a~11~. ~ ~ I T Z i ~ W - _ _ _ 14-~ - 0~- 2.. 2- , f ( 21 / +a«'c. .dt.l. ~A:r : ~•'r~~J~J _ _ . - ' - ~ _ . ty , rt.c~ I :u.r s~.. tAe dcc~s~ a4r~ ? cn . 19 ~1 ' xc~~•-J _ -,l!--T~_-- . r.o+ • ~ co.ie; ~nd :vi ~ae Jute vared ~oc.e ~ ~ ' - • • i i~AT~ S~GNED 4uD~tE+_ r PMONE = i James A. Long - Mp (3randridge, I31. 96814 ~ ~ ~ - - - - r- - - 81 ~ L+ ~ Q~ ChSPOS'i~JN 6URiAt .-~i~ ~w1~Iw~11 ; :crM '~:+wtE ~~l11Q1 ~ f ' CEMEi~kr ~8~ =~~D~:E55 vj~~~~~, ~ ~ ~ ~a4.~~oN P' R~d~Q Tt,m. La3a71 e Co. . ~ ~ "°Q ' , . - - ~inoi~ - - ° _ •_L. M. Shieid~ ~c~~ 3Z-3~ ~ :ur.?;s ' _ ~:yh.~_uRE !vu~ece ~ i• R-~tt~v2~1 ~t,~ (Sqnr~) ~ ~y ' e ~ .I ~ • • • LOCAI REt~ISTtAf • ' - - - - ~ ~ ~ - - - - - Ta: VS d~ R 200.1--BUREAU OF STATISTICS--ILUNOIS ~EPARTMENT Of PUBUC HEALTH•-SPRINGHELD : r: ~ • ~ ~ ~ ~ ~ I NF.RERY CFR4';.FY: ~TtfAT • F.e forej oi •:Q i s:. ~ r~ie ,•:d ~orr•~ cop:- of' the death reco~'d for ~ ~ the decedert.Z3qg~~,a~ ~i!erq 3 3•;d !.hat t~,i s rer_c~rd aas `s' a~ 1 iahed and filed in oq ~ offfce fn' ~kc~ ' ; t~'~,a~tq@3:,~;;,,t~,:e Frcvi~io~.s of thN 'lli..o s statutea relaLing to the . ~ regietr~t~~ri~~~';~b~s~~~~;~;r'hs and deatt~s. . _ ~ . ~ 3~. ' ~ ~ ~ r_•' : ~ DA'~ '_,,G• ~~~''~'r 1962 SIGNED , ~ ~ . !f-' *r J+~~~~+~ ~ ~r ~ ' a j' ~ ~ ~~4.. ~ ~ ~ AT ~/~/~s ILLINOiS OFFICIAL TITIE ~COUN1'Y CI$R!( ~ ! ~ . ~f~ ~ti~~~f • t•~ •,..~.'4 ' ~'~:..3-•- . ~ ~t . ~ T t : ~ ~,y ' ~f ~ ~ . , , ` S' •fy ~,a~., - L• ..t. ~ . ' ~•-Mw~ .~.•,t.• ' ~ ~ ~ 2jii/ ~a~E2492 ~ ~ • 0001. ~ , ~ ~ n ~~Ax~.a ~ ~ ~ 4 ~j ~5:.~~~?~:~.~~~*-~;._ _ ,