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Home My WebLink About2314 i~cxo~t3c ~so Legibility oi writing, typing • or grinting unee±~iafactorv in thia doc~ent ior microfile~tng. _ 3~~ CERTIFICATE OF DEATH • ~j ' ~ot~~ rK~ ~u.utt Mk?ioo~ D~non~eY ol P~AIk HwYL ».~t rw~ w.~u OtCEASEO-NAME ntf: rwat ~~s~ SEl OATE Of DEATN ~ rowtr, o~+, ~ua ~ , Floyd R. Richason , t:ale , tipril 20. 19~3 RACE M~6t0. ~l~K~N IMOI~M~ wGE-usi ~~~Af Y~O~~ 1 O~~ OAtE Of L~RTM ~ro.~~M. 0~~~ CO~M~ O~ OEA1N eK ~ f?lt~ft 1 ~~~tw0~~ 1 t1~~11 .w~. o..s MOV~S rN. ~4f 1 , white w 82 ~ April 30. 189 Kent ; ITY; VILLAGE. OR TOWNSHIP OF DEATH N+sw~ cm urm NOS~ITAI OR OMER l~SIRUTION-NANI :u Mpt w ~mu~, c~ s~a~~ .w wu.ue~ ~ sncw+ .ts o~ Na • Grand Rapids ~res Sprin~brook N,anor Sta,1E Of NRiH ~ u No~ ~ u s ~~t dT12fN Of WHAi COUNTRIf MARRIED, NEVER lAA[tlED. ~SURVIVNG'SrOUSE ~y ~.ut, ane ru~oew N~rt ~ ~ow+..y wbowFO. ono.cco ~ s.~c.. ~ ~;•iichigan ~ U~A married Gladys L. Lee SoG~t SECUMtY NU~ER uSUwl OCCU?Ai1pN ~e~a er+o or ..o~a owe w~~.~e ..os~ w KWp pf WSwESS OR MDUSiRY VW[WG 111I~ (V~N 1~ UI1~~O ~ ~r 3~-49-5523 ~y ~ales 4te resentative Z'exaco ~ES:CE~CE-SiA/E COUNT~ CITY, VILIAGE OR TOWNSHIP ~""n STIEEt APiO NUA~IER ~vecn~ ~es a «o~ :.icni~~~n ~a iCent ~k Grand ita ids ~u es 2226 3effe: son Dr. SE !:,inER-?~~/K: r~n~ .uoae usr wtO1nER-MwtDEN NM+[ rus~ wnwe usr . ,S Ri~h:ison ~ Bertha Dufz~~ne . ~~,~FQRMANI-w~Mf MAR~', wDDRESS ~s~nei o~ r.~.o. ~.o., em w ror.., s..n. i+~ q i~:rs. F,loyd R. Richason 2226 ~TC~ ferson Dn. Sc•. vratr.i i:apids, r:ic: z~:5~? ~''~~T DEATH WAS UUSED !Y~ (ENifR QY(Y Of:E CAUSE iER LP$ FOR n, b, AK17 ~ 3~wte~ru ~ ~ ~ ~fM1~'E!K Gr •!t aw~i Ot~:M II Wr10~~R C~V!! , i ~ ~ ~ >t / . % : • t ~0~ ~ . v ! a : f i . . , 1. . ~ i - ' , 11 A :C'tf:G~t`~~f O': • • / CONOIiIONS. 1~ ~M`~ I ~ . . ~ ~ ~J'Z ~ ~~KM e~vE ust ~o I (b) ~ r' ~ ! [ c / h ' e ~ ~ ^ ~.,reo~.if e•vu ~a. S oue ro, o~ ~s . co.+seooe..et w s~.nNa ~~e YMDl~~ I 1T~M(~ (~y3! l~Sf k) F~R~ II. OTHER SIGti~iKwNi C01i~tiWroS ~a+a»o..s co..~~wu.w ro eF•a ~ui ..o~ uw~o ~o uvu o~re.. n+ r~~r ~ a~ AUTpSY if YES ~?ut nMOn.as co~- I1lS d M01 !t0ltlD In DllE~riwu~p Ucl! p Of~IM Ih /1 C'. IN wCCICEt7I, SUKIOE. MO~~tK~DE. ~~TE Of R~1t1RY . ro..~w, c.r, ~c.e ~ MOVR MOW INIURY OCCURRED ~ F~^E~ wrwt d~~wn u. ~~ar ~ w r~u r.~,. i ~i ~ s?eenr ~ 1]a N~. 70c M. T60 tN1JRY Ai WORK /LACE GF WJt1Rt' r•e~, srntr, ~~cro~`, IOCATION ~ sn~n oa a.r.o. ..o., an o~ ~orw, s~w~e ~ F i3~FC~1? tES W w01 p1~C[ N04..[K. ~YIC~~~ ~ >r. PJ~ ~ _ ~ ~f vtii~f~llflN- .+ornN w• ~e.~ V ra+n~ o•• .~u ~Mi 411 SAw' MYt/M2~ AlR! ON ~ owlox~ wo~ v~nv M~ ~,s•rM rvnn~sn ~ vMr51C~wM: TO - ra+rn w. fewe ~OOr wrtl~ O[AfM_ ~~eovtr ' o~fe s.wD. io Mt us~ 1 ~RtMOID iW L ~ d nf [rA?r~L[DG[. DU! f 11~ OfCf~llD ~~Or ".`i . f 7 ~ ~.1~'' ~ ~ ~s-= ' 7 ~ ~2t~ ! • . i • .~lii. Tir. ~ : ~ I8 i0 7MF GYHISi SI~T[O. €e CtRTIfICw110N-MEDKwI EIC~~NER OR CO~O'+ER w. rwt t•s~s o• ~M FOW C~ Of~TM ~w! OlC[Of~+l w~S ?epraWw~lD Dt~D ` ! aar~ti~I1Q~~ M(M[ ~xf PNJi Of IM[ :fVV(STIG~tQ!~. r~ plMtpa~ LOMiM W~ • 11~~ MOYt ~ OGCUHlD Ow IW O~~! AMD DG~ ~O ~M! UVl[~S~ s*.rto. M 77) ~M ~ 1~ 3 CE,trFIER-NAMF mr[ oa r~u.a S~GNATUItE/ ~ % nerd~t ~o~ nrie -~~ATr SIGNE~ ~••wm, o.., ~taei ~ ~ J-~ --L - -C/~-~~~' ~~7?~ ~)k. f - ~ ~ ' s ~ 'i~%~ . J~ r_ : ~x ~ ' _ _ ' snen oe e.~ u. r.o. un oa to+++ `sT~rc tu rsniUKGADDRf55-Cf~tlFlft ~ , r!/ ' L \7.: • r -f 1' r ~,i•.~s._~. ~ ~ a~. : ~ ` e.;:+~t, CRE~+uI~Or+, PENA~wt CEMEiERV OR CRfMATORr-NwMF IOCAi10N CITY, VILLAGE, TY/F. OR i.OUNTY ai•Ti ~ s•tun. ~ Cremation Gr~celan3 Cr:=;r,atory Yent Caunty~ ~~ichi6an " DatE i.o.rtw, on, n~n FUNERAI NOME-NAAtF AND ADL~RESS ~ s~~en o~ e.r.o. ~o., u** o~ ~orrw, n~re, r~?r l,~~rry ~ ~ r.pril 23. 197 ~w ;:etcalf's F~1n~:•31 S~=rv ti;.e .inc. Grand r~a^ids ~:•:icr,lFan ~;~5~?~ fr PU•~ERAl01RECTOR-SIGNATURE ~ i REGiSTR R- I~'.NAiI;Rf ~ OwiE tECE~vtO lOC/U ~EGISitwl ~ t ~ ~ ~ ?tc ~ ~%•r: _ 1A ~ ; ~ - • - - - • ' _ .a. _ >.i-- - ^ ~ . - . , ~ S2ATE ?ffCHIGAN I, JACK nR02JK~+'.A, Clerk of the Circuit Court ~ x oY gent County do hereby certi.fy that the ~ ~nrn~v r~ x?~,t!t~~ tr r; ~_enq oF this document is a true copy af the - record no~r on file in the office of the Clerk - - = ; o~Y said County and Court. - ~ t . - 'a ~ . . ~ . ~ = IN Tr-STItIGNY ~nrrI~EOF, I have hereunto set m~ ~ ~ ' hand and official seal at the C ty af Grand , . ~ ,~B,~p~ds said County `Mhis ~Y ~ x: - _ _ ~ - '-r~ . ' pD ~ - , ~ . . . t~€q- E ~ ~ '~t. a~~ . ~ °-US~ ' ' CL£iilct~~ RT. . ~ ~ ~ ' RECuFn v`~:. t~o ~ ent y Cler ~ ~ 25 9 46 ~'75 - ~ . ~ ~ 3a~~s1 . soox~37 PACE~~12 ~ . ~ r _ f~ - _ ~ a ~ ~ ~ ~ ~ : W,.y ~ ~ . .y ~§i` 1 • r .c~~~~i.~§...^'.v.~ _ K ~ ~ ` . . , d~~. K~._ ~`d.