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HomeMy WebLinkAbout0419 ~ ~ , _ _ . . ~ _ - - - - _ 35 `V • ` • ~ , ~r~r_.~ . . ~ , ' ~ CERTIFICATE OF DEATH ' - , Dp~~aN J Ik.11~ ..i ReI~.yNWl.e Sce.l~., frwts nu Nq : ~ FLOBID~ ~caliTllAR•s no. 558 ir~e. o~ ?~t a~ ' N~MAMNT INt ~_/+AME npt a+w~~ us~ OAIE OF OEAM ~~M. wr, nu ~ ~ PT~t~C'S I~ t. F~al,e 1~ 1973 - tACE ~we, ww. ~ercw wrw. AOE-w. wa¦ ~ w w~e~ ~ D+RA~tE~ O~f M~1M iraw~. w~. COUNtt Of OEI?TN 1 . ~c. ~ wcrr~ ~L~~B ""'$''~.w~? .~oa. rn weMS .~r.. ~ 178C. - 10~ ~BrJ n ~Cj$ ~ ~ • .nw cn uru MOSl1Ul O~ 0111~ ~ r.a a~a. ww s~m ..r wws ~ i 66Q2 a ~ , Ft. P3si~oe ~'~`es M Ea~cter Ma~cloc . . ' ~ STATE Of M1~11 ~ r wo~ r ~.a~.. war Oi wMAi GOtMtR~? rwilE~. qEVEIt ~u~ED. fI011SE ~ r.Me. Nw r?~w w.r ~ Ne+w Ya~'k ~ ~ Norye f .~,~.....+ano ~ n. ww.e Ma.w ~yLL ~ uswu OOGMwnON ~«.e w o..+o.. wMe wn.r .aa a iwD Of M1s~+fSS ou R+0lnttr . t uw~. r ~e~r OCqIrO M ~OLLM YR. Mr r RMM ~ ~ . 091-03-7029 Bane MakPS ~ ~ ; «...K...a. ~ .ww¦. ~_srer~ coa+rr cm. iow~+, w touna+ _ ' F1o~3da „ St. I~uC3re t4 F't. Pierce ;K`"~`es w 1009 S. 15th St. ~ fAilit-l~MME ~rp rrw~ wr NO1FE!-MAD[N NAME wt r~w! W~ :L f~sw~.ww N- A6i4~lla Vi~.~YL~ ~ . ~ . ~iMR J• ~ " If. 1~'~MAN1 MA?!~ ADO~ESS If![r W le,. MO.. Af Ol IOrM, W~, trl ~ ~ N I~li,a Resterke _ 187.5 H9qe~ale. F't. Pi~+ce, FLor~,da 33450 •tr otwu~ wws w~o ~r= ItHree aar at uust rat u+t rC+e !.l AL ~ k~ '.ows~ o.a? . 8 . . : . N' ~ - ~ ( Q . . ' _ NI . ~ • . w ~ cow~ww.s, u uw (t . • - i • .w~cw na ~d ~ M1l ~ ~ uwa~n uw~ ~r. M q. ~s ~ mweoK«n a: N~t~rs ~q rr~M- ; a~w» t~~se uu i ~ W ~ . . M!T OiN[t S~O+p~C~Nt CCN011qnSx WM~UOw~ COwrNM q M~1r M ~qt ~tMfl~ q 4~IN 6wlM M IYf ~ M1 ~~~~r pe~ r~i K~n ~i+~i.ww°i u w ; ` a ~ur„ ; ~ N~ 14 ' ' ~.ows. ~?r, nu i NOW iMJlttr OCC1i~E0 ~ ewe ww~e p~a~ w r~w ~ o~ ~ M~ wr ~ • t .t i ~ 1w 7h M. 2il ~ ~ ~ It~{JYfY At WO~R NARy•a wor~. stat, r,K~on, lOCA110N ~ saeR p ~r.~. ro.. pn O~ ~O~w, WM 1 ~ ~ INM~? Nt p MOI ONKt UN-.fK. IiMd~~l . t ~ ~ ~ ` ~ CEITttCAiIOM- .owa . ew - ..owr ~.s nu ..r wr f?s r.iw~ rne a. ~ wI» Mor .w ~a s[wn~ OCCYMeo ~r w~a. a. ~ ? . ..owr M~ w ww ~nw wa ~.ow~ ~M, q M! Mft } MRfK~u+: Tp ~ O ~'~'R` o~o~newe. ~w 4 ~.+u~.~. M• an I l1.. _ ~ !7 n~ I.2 GI~~ uwaw ww.. ~ . tl~ ~eaue~ nor . ' t CEQrIG?T10N- W~E~ • oM ar uw woM or aw wc .w~ rw ~j . ~tYM~W~~ p M W~~ UM/O~ ~1! M7t4WqOM. M~s pMO~~. rOMI~ Mt MY rO1M ~ M~~ OOOIIrA Ow M Mt! N~ w! q Iw~ 4YM01 fu1lO. ~ K 1'A. .I . ~ ~ ~ ` r0M10. M~, 7fM1 . i / s - ~ n` ~ ' ` ~ w?RMG ~ se.... o. t.. . i+ ~ r,r , . • t /G .L cf _ I ~ iqK IIEMwva oe utrv?toer-wwf na~ a~. w~o.u ww ` Bu~3a1 F't. PieTOe Ft. Pie.roe F1aci~cla ~ I 1~ 0 ~ 1~ 1. M~, AYI ~Al IIOME-tJAJNE fNb ACOff1S 1 ftMtt M tl.~. MO.. Mt O~ IOrM. l~~N. O~ t _ . 10 1973 ~ HCt~ 9 0 1 N. 7 . F t. P i e r o F L o~ i c 3 a 3 3 4 5 0 v. s..s~z -siccw?n~ , rw. r 12~,~973 , Rw.1970 ~ - - - ~ _ k F 0 !?!tz Q~ti~RQ_EO ' ~ 1 hewby o~tifY thk t~ b~ ~ trw ~nd aor»ct oopy of !fi~ L~oal S_IUC~~ COUtitt f~A. ~ r Repiqnrs t~oord an fib t`A 1M St. Luti~ Couaty HMhh O~pNf (tOGEfi i-Otj'RAS . m~nt N Fat Piera. Florfd~. CtERX ~~"Gi1t? COURT .,.t;. . i RECOR~ YEu+=1F0 . , i ~ (Vyarninp: Not valid unle~s rals~d aeal of tM St. Lud~ • ~ . . ~,~p : c~~? ~k~ o.~~~t ~ff~x.d.~ . OCT t5 3 4sP~ M~,,,~. !r. _ . ~ } , . ,s . V t• t~ y , - S_, . N. D. MIIIER, M. D. ~a7/~ODO _ _ , ~ ~Fltalth Officu ~ Rpistrar c7 . : Y - . _ ~~i ; ~ i ~ : r ~ - . / o - ? 3 . ~ G~ '•,''c~ . .~'f i ~ ' p,~. • o.vuly laal R.oi~n•++r ~/~111 lb ; ~ . _ . . ~ I . ~ ~ ~ ~ R ~33 ~ ~4~.9 ~ ' . b40K ~ ~ ~ - ~ -t-.- ~ ~ ? ~ .ss.a . ~ _~r _.s _ ..s _ -~-~z~; r6