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Home My WebLink About2566 ; ~ srwTS ao~ cr uc~?L~n+ yCi:.i~?T~t i~.11'~ i. Or l7'cA't i-i _y.+._ _Y. t'. a u a u u o~ v~T~. ar~?Y~ar+ca arwTa Ftts r.o. ~ FLOSTDA 91 NO. REGISTRAp•0 NO. - 1. ~~ACt 0? KATN 60AZ fi0. L YtLAL RtT10t1tCtt~Lrelw.wiw.t ll:a.a.etw.: Ita:faNt~Jw~Mwiw1M1 sran e. cow~r oo~.r Fir.~7.13s ~~C i Florids Pino113s a. GTY.?01MM.O~LOC~TqM ~ l. ~S ?L.tCZ G~ 4U11N t. p/Y.70MN.0~ LOCAiqN ~ t. 131+LSi0[Mtt ~ 3dRfib Pa88det~ ~urr St. Pe~-,e2`Sb12`g BeaQh '"zcr f,s~ u"'~ ra~ ~ I. ~u?wc ar ~qw b?~ie.t. ~r.a~r.tds+~f 1. sTpics ~oc~scss ` Palms of Pasadena Iio~~ 110 r 12th Avonue 3 Q~quuu. ~a~t :.i.:its Ltu i. a?rE 1,:a~i~~ Dtf Yte? . c~u.•p?+•n -2i• ~ ~ c~c~~I13i'Ch 18 1969 ~ s. sEx t tq~o~ w ~u?a 7 wasuEO wc?~~ waaao QA?[ Oi ~IAiM .~GE ih i'~3~~ r u+~aa~ rw +r~~ H i j 1~ Wf~i~) if~ri~ 6~~ Rww YA. : ; :~a7.e t'~Iite ~~oO c:: r~a~ ? ~ 2i39? - I tOt. USY11~ OCCINAT~OII (Oitt tisl ~I ~tolt ~lf1t 11~. KKtDOf tti'•Sf.'c+`~+C't C::.YST~It 11. i1~TWUt[ lSfatf ~?/Wtl~t toY11t~/1 - ti. CifOtM ~ riYi OOIA'RS/1 ~..as.~..e dw?~~,aw. y.,w~n I•+as a h so~ct E 1? ~ i~ ,c,r~ • ~o~?r3rvit~ o.tias~chuaetts U3A C 13. FATI{ER:S ItAYE . 1~ tM[R'S 1'r11iE - ~~.s - ii. socw sccuRm ~o. i. a TY 110 ~ 12th A~ftiA ~ ' None ~t eak Bractl . St.,.P~t~rsh~ Br~u^_h Flori.da ` i~ cwuu or ousw t~rs..~t~ or.. c.~rs y~? tias~.. cb~. s~ u~.~ _ - ~xruTa~ c,aTM rA~t~ ournR~sc~uscqrr: - FILEO k~p RECOROE~ wacou~ uust c.) t RGCEr ~~tTitA ca+~ttr+e~r. ~I~. ouc so c~) ~ , LERK C+=:CUIt C4URT . r~td Na ry~ a ' ~DMS euat (iL 1 ~ : ~t~t(y t1s r~fer out To td M~! snwe lat. ~ ?A11T Il OtuO1 SrC+~~ca11t CO~It10us OOMIM~RM /o OG~N M 1[0~ REUt[01'0 nR t[~raut fi1R11 M11Mff 1(~) ~ KtF~1tYtW 3 ~No~• ~0 3~ ~:o ~6~ ~ 2pr. ~ o[su~bt ?ws auu~r octunaco. (E~rr Aornes yrya~ ts Pat t n PaH ?t y~w tlJ ~ Att10ENT Q MOYICtCC _ ~ 2At. T/ME Of NA~ ~fMfA. Dt/. ~ f1? ~3 L"~.: Mxa~r w. , , : . 0 y. A. .~~,vi4t, ~i~ a' r ~'c ZOI- INlUIIY OGCURltEO {t-/ ~1 H c'::! t~a[. wf. CITY. T8WI1.011 LCCATI~N COYIfTr ST~Tt NMII.[ AT MOT 1~MiL` s' t:S~.. dtJ ~t ~ ~K ~ ATMORr ~ ~ ~nd l~~t a~w ~ ~lir~ oe ~ ~ ~ !1• I~tt~nd~d tM Aeq~~wa~Miiif ti ~ fo J+~~ D~~th oeeurnd 1t~' `~.A-- ~-A~ on IM dats at~ted nMs~: wnd to th+ l.s~t cl m7 k•~:~~t~. froai fh~ uua~s atts~d. . ~ ?2e. itONATiJR= : ~ ; ! o~~ , 22t.0ATE5tLMt0 : ,~--/8-69 : . i.~ ~e '1 .?f'?/~ " t . Z3~. ~AL_ CJ~41i01 , ~G?~ QF auEi[kY OR CRENATONr 231. LOtAT10N lGSt1. fCSf. pns't~'+rn } eft) , . rb.~.~~w~ J ZR('~laOV.~~S~h~ r '~i,'Z l:'1~M:1 QCtflOtlJ`''31 G^*1~:''ir~;O~ t~'!.. Ot 3 : ; 2~ iU!KR1?l DtREC 071 S S TO • - ZS CATE RECD. !Y LCKAI R£G. ab. f.L('~R1~R'S 5:+.':~7~;,F ~ ~ o~a,c-~ .s~`" ~~~~r~e~a u~c~ +PF'' ~ 9 ~i ~ ` _ ~ l - s ~ A CERTIFIBD COPY MUST CAS~Y TEffi ffi~'~OSSSD SBAL OF ?HS RBGISTRAR OF VITAL STATISTICS - • - 1 hereby certi~Ey ~~?at L~~is ia s true and correct copy of a certificste = . on file in-ihe office of the Loc~l Registrar of Vital Statistica of the ~ 0 Q ~nellas County Health Department, St. Petersburg, Florid~. soor. ~ Pnc~zJ~~j Nov. 7,1974 , Deputy Lacal Registrar ~ ~ _ : . F Z' ~ . . - Y ~ .~,y A E ~ y„ - _ s.i^,~ '"7 d~ ~ ~ ~zs~F'A~` w~' _w.,w~ _ sG~,~~ J+~ _ ~ .