HomeMy WebLinkAbout2107 /y/~. O/•. 2,30/ 700
. Kf _
t.l. .tATt wowee tM Ntwt.Ttt CERTIFICATE OF DEATH
e¦••• • tlulltAY OI rRK eTAtlfrrlCe tfTATe ?IL[ NO.
1¦ •1 f••.
..i , T FLORIDA Ifto1sT11At ~ No. 340 !
ff•.•?Ir 1. ta.u N tdwfN coot No. . tffYa? w[slflawcfil•.n....e.fr..• 1!ww4n..• f..•...w...•+...wl
e¦•crtN ~,M,n Q a St•rc tou.tt
••1 •t1[ v _
1• ~•r- R f:11t, iptllfMlocAtq. r. K K•ft tM fKatN t. dn. t011tM.Ot laarlpM f. K as~ot.ct
•••••t Yftll)t cft• lwltfl I.s10t tIf• lw~tp
~ rtt•. F tts wo ns
. •aNt or IMiwI tt Mf/trtl. r?f Nrffl •It?fffl 1. st•t[• aeo•tss ~
"~*"t~*'
"t F • t Pie 230 Nfaatanazas Avenua 1
Hart N /Yr AtNrf l.•r ~ att M••ft Dq Yw
rn~rian Richard Bella •~TM Jill ? 18 1 6
- •tt [Olfl• f)A tatt t N•Illlfie ftt NMfi[• ~ Or w1N ~ ~ ai(r~ ly
•~tr~rl Yw?. • O+w rwi¦• fMIM
• . t t . Mato Ne ro tf100wt0 «t.•«e 1 '~'rV't .
f 1.1.1, Ifs•K fxcwatlal(~frr t yw RMO/lr tusrftssOt •fgllitt N•tfMl•Ct 1 •h r IrNN auM11 tsflmf s •Iftf /J01a11•ff ~ ~
• f t t I• fatq •Mr y r•rlfy fMr. rff• rJ rf1YN1
.....t None Florida U.S.A, ~
?1••t fN ?atNtts curt Nptwttf Na1•t. •art
t,.::.tt.. Richard Bo11n~0?. Elnora Shoult
!OC ltcyslff fi0 M[NAT r r A•/.n¦
263-36-73 ~ I.l'~Ci,~rr~--
,r••r•t 1 twlltt N fatnttf Atih.•w .N t•.r v/.. PI a kl.) xnf•vat tlftt.
•1?••t•f .a•tl etanf oaf catllf+t?. p(`~ Ofat11
¦r•t f11• MlHttfa/t d•!t NI _ - _ - _ - _ _ _ t ~
11/1••t• l1•Mlf•f.NN/. ~Cr"YVN f~. ~ ~ ~
.st11 t?• .tlrt r.K .itf;• OYt to Isl
l • • • 1 •fw tNlt
f•tt•tt•f Mr41 far •Nt?- tIR lf? Itl _ _ _ _ _ t
/?iy f••at luf.
•wf • • f, ?A• M fJ01n•~aYfM R fR•NI fa[ fOf~4t!• b fM R•.r+a flrYasf CO~e1/4¦ cwM fa f••r IIH wa 47ptS• 1
t•f s•w ~ • nrrnlltra
•f Nr•r• • " - - n w?
••?t•e attp,?t t„N~ „p,„t,~ ~ fKSt•1•t MOw wluar ott ••uo_ li:¦fr. ¦¦I•.e NI•h•f ti hM / r Prf N yfr¦o 111 .
•t•-••~~ p p Zg Victim _shot_ by anothor _porson- _ ~
t • T~Nt a /Nr XwM.. tw. ,
Alit';
g ; :July 18,1969
2e/ ww•f tKtu•R[O Kett W •w•r It. ? M v ¦iwr frv. 1•I C~tr. tow• ea l•+ca~w tOV11T? sr
' wwat at ~ •pt w111t ~ lr r¦rNrr. r.rA. MN~. rr.l
>ro.a at siplt
~ tl _
1 •ff•w1 /M ••e••fn1 Mw+ . fe _ _ ¦nt b¦t f•. A~~ifi•• •w _ _
D¦•Ia r•I • ~ w1 •r IM r¦f• N•r¦d • •sd re fM a¦•f w~ ar1.~a¦~p. rran fM e•v f •b •I.
a 11 f a•p • t,t • frl tL a•••tss u..-att s1aKe 1f1
t•
e••,1•l• 1 9
••f•f
•t•. Z7• f~u.ul. C1[IY.4l L7• f1[tt b¦ ~O. CtNCif~r dltaMnO.? 2L 10[anON l(YT. ?¦rw. ¦r tNMa LFrrl ~
Buis July 26 19 ine Grovo Fort Pierco Florida f ~
t.1~tt tt. aoo•[s ~ OTCO ~ o.*f •fco •r [oc?l •ra x nna• s swlatu•c
.9R.'
t•••ttte 8 AVe. Dl Jul 23 1969
E ~ ~c G t.`i RECORDED
-
4~4t139'7
'79 ~ ~ AM ~ : 41
~ - I
e _ -
1 hereby certify thb to be • true end correct copy of the lrxel ' - ~ ~ i
~ Rspistret't record on file in the St. lode County Health Depart- --,y , • ~ j
ttlenf N FoH Pierce, Fbrida. ; , ~
i (VNeming: Not valid unless raised seal of the St. lode • • . ~ E
s County Hsalth Department is sffixed.) ~ , i
.1 4 yy ~ ~
. ~ ,f
~ . .
County i~lth Officer d local Registrar ~ r,~; . • - Y ~ }
~e Deputy local Real•+?Ar - . I
d l
i
{
- - r
x=~ ~ _
w -