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t ~'~F~G"1E~'Y that the above information was taken from the Record of Death on file in this office in
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ac~ordgnce with the~lgw'of Iowa requiring filing of vital records. [r~ii;ificate No. 616 ~
Da~e~_,-_ May~9,------------ - .1979- - - - -
- County Rc~isvar and Clerk t Iowa lXatrict Court.
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