HomeMy WebLinkAbout0956 _ 5.52'~7'Ei '~~1 SEP ~ 6 AM 10 : S 1 '
. - ~ ~~~3~0
STATE OF MAINE '
CERTIFIED ABSTRACT OF A CERTIFICATE OF DEATH
OFFICE OF THE CLERK OF y~ F-*~~!HUINE '
Namo f D~ceased Sex Date of Death Ay~ Date of B~tt~
_ ' . 7 ~ u , - C - /~9s~
~.~c~~., ~ f~ ~
Place of Deatl~ ~ State _ of Birth
~ .
- ~,-~-rr-,~,~-~' 7l-~inl
Socia) Security No. Rssidence
- o o S v/ 7~ ~-c~~~ a-t-
Father's Name Mother's Name _
~
' ~~~~-t-~ .~a-~-
~ _
Cause of Dea1h f' /
~ . ~c r f _
, .
' Cc~y ~
Name of Physician
w ~ ~ l _ ~h ~ - - - - -
Name erk ording this Dea ~ Date Received by Local Registrar
; ~
y .~y` ~ _ / ~
..ttt; -+~-~G. C~ `.J ~-H~-c - ~ -
f~~
~ f _ y~,~'•~ I HEREBY C RTIFY that the foregoing is a true abstrad oF a ce~tificate of death
•~~i'+~'• ^ which is in my offici~l c tody.
- ; , i _ f~ /~I
- ; ~ ; ~sv; ~EST: ' ~-s-~' / `
, 'I i ~ ~
~ ~ 9
' .}~•;~3e ~LERK OF ~ - Maine, DATE ISSUED ~ ; ~9?
; - :
i '•~St.~;e.i'li
?
i
I .
f
t
~ V - a ~ r~
~ - ~ ~ ~n
~ ~ ` R-_^l1RN TO:
GU2iSTER. `/G,",KLEY. Cn'SE~2. StEYJAR b HfRSEY
. / P~^ffSS°C:~41 A5S'JCtaT10t1
V f1RSi NATiQ~A! 8~,:i!( 6JILDING
PAL~i SFkCiI. FIOR~::A 33i30
v
• f 1! f~ e~;, af GORQE~ ~
St.l~ ~:u1:NtY F~A. ~C~
~.,,fi'_,~`i COURT
t:f~~
~ RECO~iD rE~"
~ 26 ~ 30 ~N'1a ~
~
~
~ ~~~U
~
„ ~.~rw~.•~~..ca
~ ~~-.z ~9 PAGE148~ ' s~ ..rtr~w
~ - ?a~¦ ~ ia..
~ ~et ~..It ~.~rt
~ ~~~u C~~-
~
~ a~z~z s~s
~
.
~ _
~ -~,.°~a'•-~s,, x .,z 4, ~
i~ t ` ,x`~ .4.. -
. ~~3~'~`•~
_~r~'31~eY^~iJ . r. ~~~.49_z ~ ~R .