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HomeMy WebLinkAbout0712 ~ ~ CCRTIFICATE OF DEATH r- ~ ~si~rlZi ~ ~oc.~ r.r ~.uw~~ ~~M~ D~oaerr d P~blk WeYr suw r~t .r.u~ 0[CEAStO-r~~wt ~~~st ~~wu SE[ DAiE Of OEAM ~w~~w, e~s, ~ Joscl?h F. Slavik t malc ~ Deccraber 4, 1973 twCt vNU~. r~a~o. uencww ~waaM, AGE-i.s~ ww~ ~.r.~ v.oe~ ~ w~ DAIE Of ~iM ~rO~or. Mf. COIJNir OF DEATM ~~e. ~ f~uur ~ aa.w.~ ~.eus~ .os. wn wou~s w nu ~ • white 75 A ~ ~ Jan 1 1898 Mta ClTlf, VILLAGE, OR TOWNSFIIp Of DfA7H ~nre tm iwn MpSMt~l pR OiMER NSittYT~ON-H~w[ ~d w~ r. aw~, e«~ s~~+n wre~ ~ YICMf ~lf W MO n Gross Pt . W s ~s North R n:~uc~ 51A1E Oi ~IRM ~ a..o+ u~ v s.~., M.ne CII12[N Of WIU1i COllNTRt W1R~If~, HEYtt MAIt1tfE0, St1RYfV~'1C+ S~ONSE ~+f• ~ towa~ ~ WIDOwfD. OIVORCED ~ l~tt~r ~ .._..~~~o ' Ohio------- • U~~.~g N m~rri ~ntQinr~e_liartm n ti+t0. M Ol~M SOCUIL SECUt~l1f NUr~6ER USU~L OCCWAiION ~uw c~.o or vw~ so.r a~nw +.osr p K!O Of ~t1SlQSS O~ IWtiSittf occv~~to w r~tllK llfl. ~MN r~(tIt(0 1 ~ „ 362-02-1422 OM?ner Master Machine . ~ Ya.K. WN ~aso! ewe ~ras SitEET AND N1YVfR .o.uss~aa. REStOENCE-St~tE COUNI~ CIiY, VIIL/1iGE OR TOWNSHlP ~~s ~w Mich. Wa e ~k Grosse Pte. es 686 I~. Rcnaud /wInER-N~u+E ~~n~ roae us~ I~WiNE~-MAOEN NM~[ ~rs~ ..eou usi ~ i ~s Unkno~+n ~ Unknown ; Ir+iOR~u?~T-w~F w?lMG AODtESS ~scn~~ w e.~D- w, cn o~ w..., u~4. IMI ; ~ ~?.MrsAntoinette Slavik ~n ~ ~ = • ~w~wt! s~.+~~•u PARi 1. pfATN W/~S ~AUSEO ~Y: ~ENIEt ONII OtY C~USE ~E! (t~ f0! (o~ (DL kA ~en.u•. o~se~ ...o w..w „ WWDUH C~YS! , ,e? co~='o~iC~~ 7`~I~oM~osis ~tc~T e su.v~P,v , . .s . ~o~ka,;~.~~ o. ~OMDIt10Mf. 1/ ~pSc~ e~r~T>~ zi9~T y~11 r= wrw~CM G~r! •~Se w (6) IrrfDU~! C~YS! ~m, py~ t0. q~S w CO»uO~FK[ p: StAi1N(~ INf VNDl~- - ~tlMp (~yH 1~1f ~ 1 MRi OTNER SIGNIfKwNT CONWi1pNS~ co..ano..s taaw~*v.G q oe~a~ ~a ..or ~tunno w t•rs[ o~t.. •.s+ .~s~ ~O?SY f ~ES ~r~ .~..o~.aas ew- a ~~es o~ no~ s~otuo otns.u.n..e ews~ O O~ M~~N 1* ACCtOE?~T, SUK~DE. MOwu.'IOE. D~IE r~.a+*~. w~, •t•~ ~~~O11! ~tpw IN1Ulr OCCU[~EO 1 frlq~ ~YTI~f W wlYR r.ar ~ oa ?.n r, ww ~ ~s?tc~ri ~ I p~ ~ ~9rz NI. N1 INJ~~~• AT wORK tUCE OF W Wiv .r .ro..e. ~.a., s,ee~. ~.nw.. tOCAiION ~ smn o~ u.n_ «o., cm w ro.+u, a~~e ~ / Sre.. . ftl Ot ~+O ~ O~IKE ~iDG., tK. 13nt~n 1 !Oe 2M ~ CERT~~!UT~ON- .w.n• o~. n~u ~a.~. w• ~ue ~K~ 411 y~M Mi~/,I{~ YI~I( QM i~ oo/ao.v. ve. ~ atwrM oCCUetEO •r r.e ?uce. w ert i n-. - w~..n' Z.t ~ ! vn ..RI Ot~r • =_-x ~ Ca.K. _ -W ~ ' +•r•` .a. % i_, i --s~ ~ ~s - ~ ~ w w"~' 1 w r• ew+tta~e.ea ; )b etce.uL nov ~ ;tl~ / L - % / i JIt ~ ~ ? tlf /?V ~ 2N M. Tc b.t u::.l.a~ sun~. CESiK1UlIJr:-r~ED~CAI E7tMtiNfR OR CORO+vER o.+ n~e s.~~s p r~ .w~~ ae a.+. rMe oteeoe"* "''s ?eo"'QO'~A ~ s ~1.~ti1Y~I~OM O~ T~F WC~ ...orw r..e ~H.tsne.,,r.. w., o~..w.+. ~ .w~w w~ nu ww ~ OF~•M (sLCt;~~la O~ a! D~te ~~O 4~F ~O M~ C~YSFi~~ S~~IfD ~ ~ K i}~ K f CE~TItlt~R-NAME mn o~ ~e~..n ~ 51GtJAT oEC~ta w rrw DAiE SK,NEO ~•a+TM. e~~. iW~ ~ n•_ HuS3~ Z.~iend~rson , ~ ~ ~ ~ ~ ~ ~ ~ - ~ ` '-y MALLMt~ ~R~S, CF~i~iiio s+~[n oa ~ a o cm a i~ ~ s»t tr J~ 18~~0~ t•sack Ave. Detroi Mich. 48236 6lJ'MIAI. CFEMAiiON, fE~•AVAL CE1NEiER'I OR CEEMATORY-NAtitE IOCAiiON C17Y, Vll1ACaE, iWP_ OR COUNTY st~~[ 1 S~FC~+'~ : ~ntombment N~'oodlawn ,k Detroit, Michigan ~ i DAif ~..o~+t. p•~, iu~ ~ FJNE RAl MO.~.~f -NAME RND w ESS ~~~n[* c[ ~~.o. ..o , cm oe io.~w, s*~~[, in ~ ,N December y, 1973 n~ A.H.Peters I uneral Nome-20705 ~Sack Ave-Grosse Pte.w'ds,l?fich. B-~ - OwiE tECE•rFD ~T ~pUt lEG~SItA~ fU11ERfly,I vf1~EGTOR-SrGr+~fUAE tcEGISiI~R-)S~Gr+ti:a~tf~ / . 3-~ ty~ ,iI/~ ` '/r~• i,GL.~"J ~!G-:.CI-=e/ ~ ee% lf.. J t~ 0 AM9 RECOADE fT. t,i1C1E COUNTY F~ ' . - • ~ Il00ER PO~TRAi / ClE1tK C~gCWT COIMt J . RECOltO YE~IFIEO~...~~ STATE OF MICHIGAP7 ) ~ ~ SS ~ I~ ~ 18 P1'~'~~ i OF WAY?dE i~~?1~~IG+ ~ COU JTY ) _ . . t• - "'TSl~ZS.~IS TO CERTIFY that this is a true and complete copy of a~eaCfi Certificate on file in this office. ~ . _ Return to: : CITY OF GROSSE,POINTE {,'OODS Frank Iannelli - ~ ~ 704 Boulevard Center Bldg. , ~p:Y. ABETII E. WIEDfiUSCiI Jetroit, MiCh. 48202 , ~ Deputy City Clerk ~ ~ Bo~C~ ~ _ s:. s.. _ - - ~ _ ~ _ - - - - - _ Y.~ . _ _ a_~