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HomeMy WebLinkAbout1411 ~ 3o~s~. ~ ~ CER71FlCATE OF DE. N D.~.~.~ d Ik.id d R~4.bsl+w~.e 5~..~. ~ s~rwTC Fac NG • onivow c~ tsun~ F L O R I D A /Y?E, O~ ItlM IN REG16T11AR•f HO. ?tlMAlNMT INK SQ ~WIOOI f0l nq~ rrMt ~~sr SfI DATE OF DEAM ~~OMw, N~. nu ~ ~ FRAriK E. SHUGERT ~ f~lale ~ H RACE .rre. ww~o. u~uuM .w+.. AGE-wt w.a~ ~ n.~ uwe~ ~ o.• OATE Of ~1rM ~w..r. Mt. CO~p+ilf Of DEwM . nt. ~ wcr? ~ ww.r ~ n.q ~..os. rn waws .u.. nu ~ . White ,.7 ~ June 1$ r in , TOW?~, OR lOG?T~p+ OE~M •.aw cm u..~n MOSMTAI O4 OTMER NSfRUT10N- ~u W~ w fm~t~, 4r+~ frrlt u0 ~Ir~t~ 1 ancw~ res w ~+o . , ~ Stuart Yes "ar~ir. :%:e:~orial Hos~ital ~ STAfE Of W1M ~ r ro~ w ~.f.•., n•.~ GT12FN Of WMAi CO~INiRY ~ultwE~, ricvEt vwtRtEG. ,SUtvIVNG S ~r vrw, oat r?~st.. wi.e ~ coww+~ w~DOwED, D:vGSCFD ~ v.tr. ~ j ~.Penr,sYlvania + USA :•~arr~~d ~~t. Flcrence Shaf£er .~.~...K..,.. r w~ SOCIAI SECUbtY NUMaE! USUAI OCN~ATiON i wn a..o w w~c oo..e ouu..~ ..ou o~ Ku.~ ar wswfss pa u~ousnr . OCfM~t~ ~w wwcMD Wt. MM u~tn~te ~ ~~097-0 -5 Og ~,.:~Iana e Consultar. ~ ~~ri ment '~s~- RESWEroCE-SiwiE CWnTY t:~r, rOwr+. Ot tOCwnOca ~s~a cm u.m SiaEEi ~ ntw~E ~ - ~ ~ s?turr r!s a rq Flarida ~oSt. Lucie ~kJensen B2acr ~ fATMfR-NAME ~~p~ `Wp~ ~ wi~ jMOSNER-IiM/OfNN.WE ~ulr ~pp~~ yyt ,s David Shu zrt L'r.obt2ir:able I WORMANt-NAMf Mw11~MG wDGeESS ~ u~en o~ ~.r o. .a., cm o~ w.... f~~u. lr ~ II Florence Shu ert ~n I~ 17 Ir.dian Ri er D ~ I • ?~T L OfAM WAS UWSEO EEr~TEf Ot~IY Or+f UUSf IiR lwF fOt (el fs~ A?~D kH wwau.? o. ~ru {!TI{~M OMS(1 ~w K~iM ' "rw " € t 1•1 f ! ~ ~ • m ~ ~o~.,,,oN,. _ ~ 3D~~•-~ ~M1Cw O~rt ~~f! ~O + ~a~EO~~~~ UYS! 101. ~ • C OV/K! W " { 31AfIN6 iw~ VMOt~- E l~IMO C~VS! l~fl 5 n 6 ?ART 0. IHER SIG ~C C S: co-.a• c ..r~«~ ro -•t..~m w uuu o.• rui ~ w~ • ~T~~ t~ tE5 rue ~IMNI~Of COM• t p ~~s o~ •w~ a ie~.~ri a7lWNWO 4Y3! ¢ e ~~qMy,,~Dy O~R~11?O~tEYM1ME0 A ~ra+*w, w•, ru~ ~ NOUR ~ HOW IN)YRY OCCY~RED ~ ~Mn~ wrrM W ~»wn ~w rur ~ W?an r, wea. ~ ~ 7r ]h M.1 X!. INl{RT A7 wOR!( ?IACE Of NIUfY.~ w.e. r.o, snen, r.oa., tOCwTlpta , s*¦en oe e r.s. »o., a~. o~ ~wm. a•n ~ ~ ~wan~eso~..o~ ow~uwne..eu. ~sreer+~ ~a. . Ns ~ CEtfIfKAT10N- .~w~w e~~ nu no..m o., .e•~ '.••e uu s... ~...i~.une da r~Wow w~ v~a.~ w o[wrM OCNnEO a[ wu. o. art ~NTSK~AN: TO ~ rp..rw Wf ~{u ppt YR~ M~M. IMpY1 O~q. ~MO. q py Nit . ~ ~ ~en..eee na ~ ~ 1 ~ /6 --7~ ' ~ 'f ~ A a r? iw.n~ou, ow t1a wu•uo rw.. (ti? ~la OC 7~~ - 7M~~ w~ ro a~a c.wsus~ s*.no. ! CEfTi1CAT10N-MEDIW FJt~MMrt! OR GOeONft: o.~ n.e us~s a nr wow a a.s.. ~w~ oeeeaw+ .~f no..ow.na w.o ~ ~w..•na. w n~e ~w. w/d r.i rmt~~e.no... or..a... ..o.aw w~ re.~ wv~ p W~M OCLWfO d+ M MR w CM ~D M! C~Vff4~ fr~pO. I ~ M. 7 ~ - (.ERT{FIER ~ o~ r y 51GNAiURE o t w nw GATE S D i~*¦, o~~. n.~~ ~c~Y/C ~ ~~A I~. l~=/(o -'72. ~ ~`+c D o rtf W 70 ..n„ o.. .1 ~1yScN ~/fi ~.n 3 3 S ~ {UtlAI, TION, ~EMOVAI CfMETER~ O[ CREMATORY-NAMf i l'JUTION c~n O~ p.n+ si.n 3 „~~~Re~.oval Delray Beach Crema~or~: Delray Beach Florida ' ~ DATE ~.~.nw~~~~ 1 fUHER~.I MOME-NAME AHp ADptfSS ~ iru~t o~ ~.r.e. wo., cm w io.n+, si•r~, [~r ~ 7N 0`/ • 8 ~.Johns Funeral Hc~e 61 CoI ado Ave . Stuart Fla . ~ Y. /QiQ f~R1ERAl OR tjG{ST~SIGNAfWf ~ O~if [C ~vED ~t ~OCwt ~EGIliV~ s R~v.1910 ~ w ~ ~ Tb / ~ ' ^ '~.I~i~_•~'.~ ~ ~ - ~ . ~.r ~a, ~ i hareby ceAt'fy this to be a true and oorrect cbpy of the Loce~ 1~•:C ' f=' Regtstrar's record on fife in the Martin Counry Health D~part- ~ ~ ' !7 ~?g • ~ • s~ } ` mertt at Stwrt, Florid a. ~ . . : ~ - ~.~`i~ - REC~IR~E~irning: Not vai;d uniess ra:sed sea! of the Martin ~ LEO'AN ~OUNtY FU• County he3:sh C~: ..,.r .P .t ~s ~ffixed.) , ' ~ ~ ~ ~ ~ a c :f~. . .IUCiE P~?TitAs ~ r • ~ _ ClE ~G~p~F~EO OUR ~ R t ~ ~ ' ; L y ,;i ~+'~"+'+s-t C04t0 YE ~y~IT C N. D. N:~i. ;:1. D. t ~ ~ ~ _ l s j i,`'+~~.RE ~ 1~~ County Heaith O~ fice~ ~ lotal Re~istrar , ~ ~ ~ . , ~ ~ •3 • y ,_1i\ ~ "i, ~e ~ 7 Y ! _ _l//J l~ i ~ ~ ~ + ~~'tnf~~,l.~ ~ IS~fAf ' ~ _ . . . °,~'R ~ ~ 3ois11 soo P~sf~4~.0 ~ . .~s e.. . -