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N~ ~n I,.__. Stanley___ F,__ Biale cki______________ Register of DeeJs in and for
Racine County, State of Wisconsin, do hereby cenify that the ~•ithin copy of__
, Death__Recvrd__ of__Melvia_ Ellsvorth__Har~_____;s a true transcript
of the original mpy of the whole thereof, now on filc and of retord in my oHice.
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! I furthertettif~ that the original waz 61ed in my oHice ct~e___.__.llth__ _
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j day of----~--~ ~:~Y.~~~a---~.Q74------------------- Vol.-----LOQ_ PaB~-----_4IIL
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~ =~Cf'~L~~S m~ hajod `and oHicial seal, at my oR.. _ in Racinc, ~~'isconsin, this -
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` F ~ED AND RE~~~~ ~
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` ROGER P~17RA ~
i CLERK CIRCUIt COURT
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