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HomeMy WebLinkAbout0953 3867'75 ' ~ ~ a: F'i~?S . ~ ~:.F' K~. ~ CUIT CC"~' _ . ~ r, oF_r_ 1 12 s~ PN'1~ IN RE: Lots 1 and 2, 81ock 1, SERVICE HOME BUILDERS, INC. SUB- DIVISION, as per plat thereof on file in Plat Book 7, page 17, public records of St. Lucie County, Florida. 366'7'75 DEATH CERTIFICATE OF EDDIE D. JOHNSON C E R T i:~'~y~D, C Q P Y 2~52 ~ 413 . WE HEREBY CERTiFY TNE GO~'\' REPRODUCED BEI~)W Tt) BE A TRUE AN~ CORRECT COPY OF TNE OR1GffVAL _ftf~(~aORD ON FILE IN THE f3URE Au uF VITAL SIATISTICS OF TNE STATE OF FLOR~~A, DE'P9A~tTM~(dT OF HEAIT.H AN[? REHABII.~TATIVE SERVICE5 UIVIS~ON s. OF HEALTH AT JAGKSANVtL,~,E.. FLORIDA. _ . INOT VALID UNlE55 TN~~SEAL QE~'S?,~E;~A« 0~ ~~R~OA. (~EPANIMCNI l~f NLAIIN AhD R[~~Ati't~lAl10E 6ERVICEB. DIVISION OF~l~EA~tF1 IS.I'I,~jV(,i0j1`~~ ' ~ A n(~ ~ - . a:.:.= ~ f.'; !j ~"~+~,+~,A'l ~ ~.7~' _b'"''~ ° ~ ~ ~ ~ ~ ' , ,O , - ~ 'i-.`' ; : ~ ~ ~ ~ ~ • • , 4 ~ . CH~[f. oUA[AU U• VITAL lIAIIST/Ci ~ ~ ' - • . ~ ~ i t • ~ y?Vt1i?Y ~ r . : < . . ~ . ~i~a~`~. ~`~t .h~~, ..Y.r.r. ~ - ;j ~ e ~ . ~ fTAT[ 11EGqTRA1~. O~REGiOR. DIVHION bF ` r" ~ - • i • ~ HtAL~N - DVAIITM[NT Oi H[ALtM ANO • 1• J REMA~ILITATIVE i[IIVICC! ,f~'. . '~i• + ~ :~t;,.'' 2 CERTIFICATE OF DEATH 7~-0 6 4 3~! :l Dep~rterot of ile~ld ~ad R~ly6~l~u~we ~o~'~~'' QTATE Fi~` Ho. ~M~~~~~~-•~~~~ FLORIDA ~ ~os~n.?a.sris - • pEGI6TRAR S NO ~ DKEASE~-NA~tE ..~sr ~oa~ ••s• Sfy OwIF Of OEw1N •o»r~, o.. i , L~ . .iobnson « M~~ ~n:iowr 2~ iy~i t~CE ~n. Mecw...ir•:.w ...e..~. ~ wGE-usr ~»u~ ~.e.~ u1+Df~ ~ D~• DATE Of ~I~?M ...Own., D~r_ ;CQ(j~1T~ Of OfAiM nc ~ s?ecr• ~ , uer..a.. .~us~ ~.oi • o.~s ~~s , ••r• ; •u~ ~ , Negro ,s~ 72 w , ~ Oct. 1 18 St. Luci~ CfTI. TOWN. O~ 10CAT10N O~ DE~iH ~MUOt tm ~r~n aOShTwI OR OiHEf ~iSi~TUtIW+-?~~ueE ~~i ..o* ua~• ..o ~.,..u¦ . sncu. .es o• .w „ Fort Pi~res -X~~ Fort Pierc• r+~morial Hospital - ~ 1 S~A1E Of iiR1M ~u ~or u~ u s• rue C~nZEN Oi Mmni COU~+Tlr MARRIED. NEVER MARRtE~. ~SUtvWN('s S?OUSE ~+r M~~~. o~~~ .u~vt~+ rure ~ ~ I caa.a. ~ Nt WED. - CE~ ~ sr[cr.. _ - - - - - ~ , Florida . U. S. ,~~arr~~ `,i~,a~ds For~a : SOCI/LL SEGUbTV WM{ER ~USUAL OCCU~ATIOfi :`~~t ~o.o O~ r'Gaa wwe ow~w~ .ws* o~ I„y.~p Of WSWfSS OR INDUSTD~ ~ ' ~~Oa~K. uq. trir v~t~'~Po i i s „ 2 6 4- 8 t f-0083 M~nist~r ~~n Rsli ous Fducation E 1 RfS10ENCE-Si~tE COUNTT GTI, tOwN. O! IOCA(ICN ~~~s SiREEi ~.ND NUWEk ! k s?e<~~• ~es o~ »O r ~ Florida St. Luci• Fort Pierc• Yes ~~.b01 North 15th Street iATHER-N~ME ~~qf rWOat t~51 MO1MfA-MA~ENltAIME ~~~5~ r+pp,F uS~ ~ ,S Julius H Johnson Hatti• Duhart INiORAMNT-NAME ~MUN!NG ADGQESS ~.5r~[f~ t7~ ~ r D MO, c~t. p~ *or.., S•~~t. !~?l Ha~ad~ Johnaon ~,n601 North i5th Street Fort Pierce Florida 334 0 P~~ ~ pEwTM w~5 CJWSEO ;EurE~ O~rir OroE UuSf iEr uaf rOO oL ~e , ~~+0 r~,; •~•~o¦~... e~ e.u ( ) un.~[t.. or.ut ...o w.T~ li W+~=LR C~ust ~ . - ^ W - f. t> ~ ~ - ~ r" ^ _ - - ' . .s • •.sFO~n.~ce o - : f~T+'11 CflMDIIiOMS. 11 •V1. ' ~ v ~ . ~~~cr. o~re r.si rc ~ Id' f'~) ~ ~rrlDUtf C~uSE ~o•. _ . . ~ SiATIMG 1Mf ~.oa. ~ 1C. O~ ~1 ~ <Gw;lO':~~+Cf O~ ~~a--' ~~1~4 lQY?! l.~)\ t ~ {~1 4~fT p OTNfR 51GNKKANT CON0~110?~5 cpro~*~a.s co.n~.~un~+c •o o~.r~ w wor m.•to +c c.~se ..r ~~a~ -~-TA ~ u ~S rlll ~~MD~MGS cou~ ~~.~p +o+ Lntuo o~te~.~.wy~u~te O a o~•rw - i,~~i ~ i?.oEopl~f ACUDENT, SUit~DE O~~ DA E INIU~Y ~.o~+rn. w~. ~e.~: NOUk ;MOW ~N/UR? OCCUR~ED ~ rr+*ff,rju~t a1'Q~dn ~w r.~r ~ p~ r~~r u, r~ ~+oµKioE. OR tJ?aEiEW1u.ED ' ~ - _ ~ ~t (SO~u~I) • { ~ -a G ~ 700 ' i 79~ M ; 701 T C - - - - " tN1Ul~ AT WORK " r?IACE Of w/URr.i «o..e. s•ntt, .•ro~•. i IOC~TtO?a • sne~, o~ e r o . or. p~~o~. v'~t s' , anon rea m~o ~ tor.Ke wso . ea ~ snc~r. ~ . 1 ~l0~ ~7M ~ __-r ~ ~ ' CERf!ilUT1pN- .cr~•K w• ri.e , .o..ti. o.. .t.~ .~o ..s~ s.~ «Y+ »n .u.i o•+ D~D.'D~O ti0' .'t+ ,we Df~tM CCCUtifO m~ ruct. a. n.e •MISKInM: TO ~ rO~~w 0~• s~~• ' ~7J• ~1*1~ 0e~'~• rCU~~ D~R. ~wC PO Mf NS~ I ~REMOlO fN( ~ ~1~ ~ /r W ~t ~~+O~llOGt [J~ 70 M[ (~yy~+1~ i~~~t0 ~ it~ oecuuo ~~or Z~ ~ Ci 7i~ Z~} ~ 1 I~~ 1 f ~ f 2i1 (i ~a S: ~~i~ M ~ CERTIfIGiION-/MEOKwI U~~tMf! OR COitOt~ER o« r»~ ~•s:s w~~e wo~~ w a.~. ~M~ OKIAIN~ ..s nww~ceo cr.e e.w.~...no.. w nw wo. uro o~ r.~ IMISIIli~f1ON~ ~M o.~~~o•,, ~ ..o.+» o.. ~e.,• et.M oetutno w w~e o.n ..~t oM ro r~t c~use s~ s••~to M~1h ~ ;F 17~ _ _ M ~ CE~TIRER-NAMf ~f:re o~ ~rnM• - - ,1 S~GN ,RE~ , . or,~..ee a ,.ne ~DAiE SIGNEO ~.o~rn o~•. •e•u ~ 77~ r~r : r:n ~ tT ~ - 1r•' t~ • ~ • !tA ' - 'r - :7k /~'/71__ ~ ?uUIING S~ CERTIlIE s.uer o~ ~ r o o ur= a?q,~.« sua nr ~r~ ,r'~, 7~~. ~r. ~-?r•t ~ i~r~A, F~~lori~?a ??l:~.~ dUR1A?. (.RE11MTqH. RFMOVAI ~CfME7ERr OR CREMAipRr-?~~ME ' IOC~i~pN c~n ca rc..~ sr.~~ snun ~ ! ~ R,~maval i Sha C~rav~ Cemet~ r lcridi . ' - - - - - r~-. t------ ~ OATE ~ r0~•'w, 0~~, N~ ~~UNEtAI NOME-~~~ME AND AQLfESS snea o~ o wo . cm w st.n, ,M 1 Ston~ Bros. 1 N. th St. Fot~r ~~ra~~ ~orida 33450 ~ p~_ rurE _yc.r+~ru+~~ O~TE ~EC(rvt0 ~OUt eEG~St~~~ ~ y , ~ !~ct~'• f , 1 ~ ~ ~ 6u:~12~ ~t i' -