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HomeMy WebLinkAbout0434 7~-- 2;; ~ 7 I b 26t999~~ 7 3- 2~? 7 7~ C~PTl~IC~TE QF QEAT!-t ~p~tlAt~d e~ ~~~.~~Iti Mn~~ ~~~~a~.i~itwlht V~~itts F L O R I D A aTATE FILE NO. IN\IVII\ IN~ It~ \I 111 I~?F. Ot it~Nt IN ~"~'~w•nuR.+u.¦' _ REGISTRAR'S ?JO Ii1tMArllNi INK DI~kASIU^NAME ~~~f1 rwo~l ~~~t SEA OAIE Ui OEAIM ~ ~ow~n, D~~, ~1~~ ~ ~ Si( MuDl07~ F01 a;;io(u0K ~ i u Q~~Cli t~ ~ (~rt- n2• r r O 1 O? ~ RAC[ .w~r~. www. .u~K~w wou.., wGE-~.~~ o~we ~ n~_ ~u+oi~ ~ o.. OwtE Of UtlN ~.o«~r, o~~. COUNIY Oi 0[wSN Z . ' uc. ~ ancu. ~ au+o.. ni.n~ ws-T1 w.t .cva n•~ ~ C~ ~ ~lilZ.C_ f. S! S. ~~.,'Q1'_a~~.c~.~.-_~ ~ ~r• ~V`AlJ:lt`('~ CIT~, IOVYN. OR lOCw110N Of DEA1N wf~ot c~n ~wu~ NOSh1Al OR OINf~ r~S111UilON=?rAh~[ w~ ~~t^~~, ~n~ ~~n~~ w~"~~~ ~ ~ ~ rh o. ~o „ h Ft. 1_rudc~rc~•11~ Y~s__ 11Q1.1' r~ss~los~i~s.L ~ ST41E G ~1tM ~ ~Ot w Y a~., ti~r1 iGt11[N W~MMAT COUNIRY W~RRiED, PtEvE! wtwkR~ED, SUiVIV WG S1'OUSE ~N v+~~t, o~•e r~wlN wrf : cq~.r~n WIOOwEO. 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O~ INlY~t ~M ~ut ~ o~ r.n n, ~ter ~ IqMKJDFr,O[ Ut~EIERMUaED ~+~rl ~ ~k- M 701 ~ IN1URr A1 WOR~C KACE Of w/URY ~o..e. ~.~r, aT~e~*, ~~o~~, 1OU11pN ~ sn[e~ c~ ~.r_o. wo., on m~orN, ~i~ie ~ ~sncur ~es o. »o~ d~Kl MOG.,tK ~s.eur., 7or 2M ~ ~ER11fKAilOP1- rOwiw M~ fl~t I ~OMM D~t 7l~~ 4Si Sl1~ll MW/M{~ ~url Ou ~ M~~~O uOt r~[w dt DFA~N OCCUlGED •t tw[ rUCt. 6-~ fN~SKura: ra+ih o•+ nu ~oo~ •~rt~ oewm. ~wc~~; o.re, ...n. +v •esr ~.n~uoeo rwe ~ s~ TO tl• oec[.uo r.o+ ~)1? t)•~ 9-- 197 3 7~~ ` 7- 7 3 7t1 tle y~~ M O twE c uu s~ i~.•e-_ CER11fKwirOe+-~rEDKwt EK~M~trER OR CGPO~~EA o.~ r«a ~.in a rne ~w„a o~ u.r.. ~~t oeceoe.+i .•s ?ao..w.~c~o ouo ~a.~~...no.. o~ r..e WD~ .~oio~ ~~e w.rts~~.:.•.o,.. aw~o.., .a+rN o.r n.e Mou~ - o~.~~ occuuto w ew o.+e ...o oui ro The c.uun~ vteo. ' 1L M 17~ M CERtIfiER-?~Ah~E ~n?e o~ ~~.~n / 51GNwTUR~, / otcu Ot T~Rf OAiE S~GNED ~+o..f~. o.., .e.~. - :~ln~~ ~ .~C E~t/2c ~tl u . n~ ~ ~~~«q«/ ~k /a- /o - 73 ~ -1~-- ' M~AWG wD.~aE55-Ci.!;.~sQ an.r y~ C~~- sr.rt tu 771 j ~ ~L ~ lt~~P-T ~ _~l • ~~~f r~Lt~f ! ~URIAI, ~REMAl1ON, ifMOYAt CFMEIERf OR CREMATUk!-N4!yfE' • IOCATION 4~~ O~ tO~+n ]~~tE ~T 1 ptC~Q ~ ? 5! Ruri , ~ueen of Heaven Po~ ~no Beach, Florida r- . - OAIE - ~..o..tN, w~, ~tu~ fUNERAI MOME-NAARE AND ADDiE55 +suie~ o~ ~J.D. w0., C~*~ M fp.r.1, STwtl, b? ~ ~OO 1 • r~ ^ St • Tri Q~t~._22 -l.. - :H t ~ 1~ • p.. 1 ...y 7 -..,r -ii- , n ! ~ Y. 161Z FUNERAIf) ~ OR-S.iGNA(~~ ~EGiSiF~R-LGv~fuf~E o~r[ ~EGf~~~fD ~QC~: FkGiStt4~' ~ ~ Rev.1970 c~ ~ , r~ {Lt~F . IL} ~c.-~ ~ 7A . ~ ~ ~ 7fs n . ^ -1~^ ~ l`l~.r(i (2e? ~ ' ' / r . _ ;'v ( r.'_ t~f rl.:i;~ ( ~?.-,S ~y,-y~ # - - • ' : r~~''J~iT'a 4!_t~~~,, !~w , • , V~.fta ~ ~ 1..~ ,E. ~i: ST~ ..y ; ~ - . OBEI, y ~J'.iY C.:uPT~^.! ;,p , x hercby certify the t~bove to be a true as~d correct copy of tl:e Locu~ ~ Rc~iutr.~r'r~ recoi-ci on fil,c in tlic IIroxni•d County J~calth Depart~~ent at - ~'ort I.audcrdu~c ~ Florida. ~ ~ ~ - " ~ (h'urnin~: tiot vulid unlcs~ raiacd scal of thc Broward County ~iculth r~ ~ • ~opu~t,i~n~ ;ic uffixcd.) - ~ ~ $ . . . ,.l,....,~~ t • ' . • , . + . V ~ . ~ ~ ' - 1~ . ~ •~~z~~cr : ~ ~a ~ , ~ ~ ' Gl~ ~?'•~%f'~'j-'~ ; .%'--s!f-'~. ~ . ~ 11-1-73 ~ : _ . ~ n R ' ~ ~ . ~ , ~ : . Y- : .~ounty Ilcaltli O:fic~ ~nd Local I:c??.i~Lrn_r r, _ ~ `J f 4 . ~ ~ ~4 ~'i+~~~.: +y _ /I - ' • ~ . • ; ' r ± e ~ t ~ : <<~~ ~ ~,~~J ~~j~ p ?i • 'j'•~ ~ /J/~ . r.. , ~i ~ . ' ~ ' w Ii . ~ ' " ' llcputy Loc.1]. ltr~;ictrr,l• 'x • . . . ~ 2~~1~ RETUR\ TO: ~ vICHOLAS J. 1~IARGARITIS , ESQ. Fit~p fiNf? REGQa0E0 303 S. E 17th Street, Suite 20$ ST. LUCic GG~JNTY fLA. ROCE? i'G~;RAS ~ ~ ~ C~E~x ~t~~Ct1iY COURT ort Lauderdale, Florida 333 16 ;K;: ~ Rfi ORC Y~':':E~~..~••r , ~ ~Oy ZI I 33 PN'73 ` ~ EpC~. ~.~?1 P!1UE ~Rs