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CERTIFICATE OF DEATH
~ep~A~esl eF Ik~111 ~w~ RelubllNathe $nvices fTAT[ FIL! NO. ' ~
a~~ ~~+~A~.~~~ F L O A I D A
tr?E, l ItIN1 IN ~"~~~~~"^O R[GIiTRAR•• NO. ~ ~
~ttqAMNT INK ~~A_N~ ~yi~ ..,eMf ut~ ~X OAiE O~ OEAM ~+oMrr, o•r, ~
SEE IW~100[ f0t
"~T0'~ ~ Els Zie ler :.Female ~ Januar 14 1975
tACE M+n..~toeo..re~w~« ~wu», AGE-us~ w~a~ ~.eu w~a~ ~ a.. OwTE O? WTH ~ra+M. o.r. COlxiT11 Oi OEI?TM
• ~K. ~ MKin ~ M~wwr ~ ru~s ~ ~oL ~n ~ouas ,w. ~ ?
• ' ite ~ 74 ~ ~ Nov. 27 1900 Broward
, TOWN. OR lOG?T10N OF OfwM ws~se un .~rwt MOSMfAI OR OlllER NSi1TUT10N- ~ u.o~ w e~n~~, a~.e s+r~~ uo .nwe~ ~
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S~ATE OF ~R1M ~ r w0~ w ~.s.~., wri G11ZBd Of YYIIAT C01JHit~ MARRIEO, tdEVER MARdEO, SURVNNG Sr01lSE ~u ~rw, o~re ~uieew ~wrt ~
oows. ~ wDOwEO ~ ~recr. ~ •
tl~ m n U. S. A. N Widow~ec~ . "
M socuu aECwrrr R uw~u aawwnon ~a.~ o..w~ oo.~a o~.~.~o r~+ a? uw o+ ~usrrtss at wousnrr
occvuee M ~Mb u[, l~rew r nn~~ ~
- - 70 ~k Hou sewif e Own Home
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i ~~.Broward Ft.Lauderdale ~u.No 4820 N.E.2nd.Rve.
fATMER-NAME r~W ~ION~ uW MOTI~!-MMDEN HM1E ~uu rwae uW
~s. Jacob Rein Paula Lutz
~ INlORMAM-NAME w?IING ADfiRESS ~inen a u.e. uo., ar. a a.~.~, u•w, tw~
~ ~h Heinz W.Zie ler „~4451 N.YY.19th.Ave.-Ft.Lauderdale, Fla.
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CHTIRE!-N~ME mre a.n.n e a DA SIGnEp ~..o..n.. o.,..w~
n.. oward RoAbel M.D. ~~r._ l 1/16/75
~`~~t~-`~ ~.~.17th.Street ~t~~~~~~ Ft.~au~erdale, ori~a j"
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i WR1AL. QEMATION. ~ErOVAI • CEMETERII OR CRfMATORr-N.utif IOCAl10N un o~ ~o~rr. it~n
~ wunr ~
E t« ABCO Cremator ~ Ft.Lauderdale, Flor~.da
i ~'7'^~ DATE ~ ranrw. ws, nwa ~ FUNERAI MOME-NAME ~ND ~DOtfSS ~ srner o~ ~.r.o. ~+o.. c-r w wrM. u•~~, ru ~
!,1i n. ohn -3 0 ndrew ve. oLa der a e Fla.
' v• 5. ~614 fuNERAI DIfECTUIt-51G+uTUIf.. f REG~St SiGn~tu~ ~ • ` ~re [ {~[o ~,tou~ttc's~au ~
' R~V.1970 ~ - / _.,lct .~~~"f.r? Q O ~ !
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CERTIFIED COPY
I hereby certify the above to be a true and correct copy of the Local
' Registrar•s record on file in the Broward County Health Deparoment at
FQ~~~~~ex~ale, Florida.
; C~~1t1~Y iiF,'~'tll
j t
{~ming: ~1o~~valid unless raised seal of the Broward County Health
-0 ~~g:~TY ; '
~ .~F~•~yTR~~e~a~t~aent is affixed.)
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° r,r •~`TZ~t•'!UA = County Health Offic and Local Registrar- ~
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~ 'j~ ~ :ys~ RECORD AND RETURN T~
O
f ~ _ JA :tES A. CABLER, JR.
~ '~~~'jtr C'4 a 1 400 E. PR'iS~'ECT I'D.
U k c ' ~u~~:,o~~F. F u.
BO~K~J~ PAGE~~~~~ Deputy Loc~' Registrar '
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