HomeMy WebLinkAbout0228 • 4,
- Porto 04-23056291 ~
/ ~
1
~~SrJ '
• r -
• CEORRilAOE/ART31tNTAFNUiANRESOVRtq ~ 11 ~ ~
• VRAIRECtIRhSUNI?
CERTIFICATFAFDEATH trfe.Fww. _ ~
nr~o~r nlr.~rr 7 O t
• OEEEASLO a 1 'par n w
ry-b~r w e c O e °EATat Juno ?7. t 4 :
r A.i•wa•aai' wt.?~•.n......~
• arr •.w • fy •wtat wtlw• wr StN! GdOP~ a C~ww/r ~g~rAP .h 7r ~ ...-Tit • t
~ Ovi• Qw LIw.3/wta Wr•S UN• L.t1:.i««•TT~
' Dsvoreat - ;N;• Uersoroat re. i
• mar
w~T'N•y. « f.tla•w. • l•+Mw wr •«t wwlat « w . fa•.
Habsrancn county hed~C.c11 Contdr y r.ln
t~y+ Ilyf fARYt Ww1AL 011•
_ K it a~at09. Co. Ind. U.`'.a. wcYOVwE
. v.~Plas w[vwrlon~[!~~
¦•w wwt. f••I ww••a t. t...uu
YR MIW71 f+•la•t otrt NtIM3 Yra. OV ~ V.~.Ir1f.'ed t0 ~vl••w l1 •rr •.w ,,,,T t~
' • :rao~r~~ni ver, i t Atl _j~~=-
' 1 YAww1(O Jk~V[w uAwwKO Hwy..yrN•••wNrMWIIM.~ Mar•4.t •FAg •.ww
OwltppwEO ~ UOIYORCCO M+wNw••trwN.
> OsS?w~w~[o ~ •
I ~ Il. VSVAE OCCWAt10N Ic • •w wo.•: ~•pi~wttf•, ttNwW/ 11. f VN[RAt nOY[
Mw• M W Iwot1 •t .w.w i./•. •w• w .K.t{I 1
~ ~ itetireu I.i:.iytur i7t.t.. ~ hcGEi:ee-~,riflin '
U. NAS OEC[AS[D [V[w tN VS. ARM[O fOwCE1• S•tW S•crar !(1l.fVNERAE NOME AOOR(SS
ry•/. w•• r rMMwwl Ila r•tM•• wM M MI•t M tKwW1
N 1)-fATatER'S f1I?YC ~ .IN[ORYAN[ RNNaMttw•
~ ~.a EttE H. O don
~ ~ ' //•E R' YAIL MIdWE LWfORYANTY A00RESS
~ ~ ~ Core~F~"°rrill De-orest Ga.
- ~ 7i, N wltl Wr ~w• t1YM Nr kM .l0). KI. _ 1 w NN IM . • • M K
a ~ OwNt fb N•Iw ! 1.
V ~ MRT I. DEATH wAS CAVSEO Rr, t
IYYEWATE CAVSE la
t.
W S ~~M •
= Z tYy.talwt a aw?. OVE TO
/.3 wwaw M•• Ia• to _ S.
aeew tavN Iat.
. ~ = walwy 1M Yw•N•
O ILrt~catm u. OVE TO c
~ 1ARTRl. Otwe. M{n.IK1M tOwO~s~s_ewtr+~»aq to Y WI w4t ft41N t0 IM /N.w.wM En.Jff tOM.IMw t'.KI M ENI i 111. )1. AV 1 OOSV /
' • ~ 3 ~rss~~
sN~t~~ S ~~'_:yc\~~~~~~~- a ~
1
_ 7 . c L~ 1i. ' t C~• ~ ~ r, :.t 1~1•
v tt. 1 A ~_~-~:~Z ~ M 1 FDA
. W ~ CowVl•L• INwIT S{ a W OPERATION
r ~ r
< )S. t •1y s•t Ir IwM 1 NtMtf•O lM Nt••twf boles pH •
Y If1.~, is`- _ 7! l1, tM!
I~ ~/~M w•ceKN _ `.t~
• y MltwM ~ v..~r.... 7 .1)[~_,aw0 In1t •tt r1 _A`1_ {,~~1• •NS /
~ ~ Ma1w «tr• aim ~ S~t~ .w _ ww, tl•t ra...et aro 1~• sate +lalrt aeon ~ ~.t ~~1..... ~ \ ` - ~T`~' r ] ` 7Y
1 (~••^.'•~t ll-C/.L;c'Tt r'\a.t•t?ER-~11~".y'14?
• v t7. ACUOENt Itaat o/ twlrr u.•. •w a ao+ut Ir¦ tK tu.a• tC•+r a tawnl I(.oawtrl IStatq L.ne p+.r •?•I duT1 1+•N/ 1•wrl
2 OSUKIDE O^owl•. tatwt, fatter. ultet UtArxae al .w. of
t _ O•tOt•KIpE l7 eOa• wWr., {tt.1 I .~IVOI rwwe N wor¦ I - ~IMr1/
$ 1/•w w rllrr our/ .
• R~Tf CORONER [O Ce.wlwY YYtalr• A/Or•N •
lf. OAIC wECE1VE0 )O.R , KT~7ARY SIGNATV A~arHt N~/1t wt ~7
. ~AE R Get A ~ •t ~~-i~~ /
• - s
,
t
This is to certify that this is a true and coraect"~copy,of
the certificate filed faith the Vital- Ptecords ServiF~ f:eorgi~
Departtl~nt of l:ur~an Paesources. This certified co yc~-is•~issu~~
under the authoritq of Chapter 88-17, Vital Recos,tyQode'~ofi~ 7
1
• GeorFiaf annotatc~da as amended. ~
.
~ s•'
ti~ County • ,fi.! ~ : t
• ' Custodian • ~ ''I~f ~
State Vital }:ecorcis , , • •+y
- Registrar anu Custodian Issued Ti}* ~ ! ~j~
D:xector, t'ital F.ecorcis (Void wit out or~zna, ~ gr~~~ ~ e ' 8 ~.s
Service and imp:.essed seal) -•~~r"•. t
f
.
r
• s R ~ ~
A ~
• ,
~ 8n`'1~~1~ ~~GE ~ ~ • ~co~pvfWf~o •1
• ~1~_
. .it
•