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IN THE CIRCUIT COURT OF THE TWELFTH
JUDICIAL CIRCUIT IN AND FOR MANATEE
COUNTY,-STATE OF FLORIDA.
CASE NOr P 79-390; 52-264
IN RE: Estate of GEORGE I. KEGG, ) 4
X20
Deceased, )
1919 SEP 28 p}; 12: 28
'A~D RECOyyitOifEiip
CERTIFICATE OF DEATH RECOR01?ERIf!£0~.
orl,..E.t.E .t tId WLe`IiMeTEre ~ettt~t. FLORIDA ETTATC Erne No.
twwnow Eir EEE~?LITT
- ttarewaww/to
• acGTE~rftAw•s Ko
OECEnSEO-NAME /~tst ' .wta un SE>t GATE W pEAM • wowrr• e•r, rtu:
t George uilliam RHGG , i`tale , t4arch 22, 1;''; 2
RACE rwrt, wtaq. •rtK•w r//eu«, AGE-ust urwet t au riryte t we OATS Of E~MTM tro./r, wr, COUNTV q DEATH
erc / Wtrr . - Ntlwe•r ~ rt•tL +wt wrt wOYtt rrw 7•V /
white 55 s< . i t u. 1916 „ P1NF=tea.
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fttcrr rtt W ro
T+ BAY PINES e$ „ YA CENTER BAY PINES Ftl~
STATE Of WTIt r r wp t, , «•rt CRIiEN Of VvNAi COlNitt MARtlEO• NEVER MAYIEO• SNtVIVNG S1'Ciu3f . d r.re.
c.re r~ee« .ua. - -
cot/«m / ice. M/R>~p. pIVORC~ / wcrn
~ Indiana _ _ t Wa? » (jlvorce(j _ _
SOCuI StCURit? 1V11WFf: USUA1 OCCU?iTgM /w+i
rare p row ear ow«c +ou p RND Or fNfSNESS Oi n~uSTRr - - - - - - -
- r/OtarO L1N, irtw r MhtN /
304 09 68 43 IT. Ca enter - - - - _
RESIDENCE-STA/E COIINit Ctir, iOwN, OR tOCAl1ON •/swt ctn trrt SHEET AND NUWER _ -
Florida Manatee ~ Bradenton ~ ;ttr" ee ~
Y ,t. 5204 19th Street S~Jest
M1gER-NAME twsr .twat ust MOTHER-MAIDEN NAME /.tSt .wtat Wr
?s Geor a I. Kegg glary Gilles
INfORMANt~NAME PAUL 1. GIBES Iw1?EtR+G~ADORESS .swn a . / e w . crr p ro.«, st.n, r+.
IT. CtllEf MEDICAL A , In YR CENTER BAY PiNESr FU1. YA MOSP
?ART 1 OEA1N WAS CAUSED Rt ~fNTfR ONtr ONE CAUSE iER lNE N~ p,, pL AND ,tM ..~:;e« o n + w a:+r
q twe.at avu
a~llnlnutritioa, ee~ers 10 years
tOwN1/Owt, rt •«r,
~rKw ..n n,Cirrboais of liver 15 years
rrtrter•rc C•rft IM, jy~ li'i. Ot • tOwltalf«t! p
tt•tr«G t11t Ywelt-
°'r° `~ra E„Chronic alcoholics 30years
?ART s OTMEt SlGttrICANT CONWTIOttS: cowaeows co«/wru.rc q et•e/ trr wor aurae ro cwst c/nw w rut / q AIROKtr K TES wta /.we.wos cow-
- - ~rtt W w0. LOtttO /w tttftw~wrrG GwL
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INAK1 AT w'ORIC fTACE Of NJIJRt •r rrawr, r.rw, trtrlr, /.[qtr,
i sttc/n ns a wo i owrct t•sa . trc .shun . tOCw110?t / smn w ¦ r o «o , an o. ro..w. sr.n .
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T1e ettt.tte /.e.. 3 22 72 3 22 .72
i~N TTr 3 22 72 did „~'t!,s35PM ot~:~
CERTMIGwTION-M®IGAt ET(AStltER OR CO:OttER: ow snt t.srs p er now p ot•tw rwt eKteer.t .eowou..cin
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~`w OCCUttle Orr M wA •rre etr q u/t 4Yet~S'?~4[3i+r t!! J~~, M w0«tw O.s re.. - .V~.
CERMIER-NAME mN or ?trro - ~ . - - - _ q4u/ w ~a Ow
E~S'1Gt+EC .+cr.~
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TL AIIS/1tIN P. BO vr~.. , ~ -~w Q,~,` • it~~ 3-23-72
AtwasrtG ADOE~SS-ffR?~IFR ? • srt~t?9, t • .ro .n oe qrw'-- sr•n r.r - -
JL ~
WfIAI. CREMATION REMOVAL RY qR E .rN ~ lOC1?TION t•~• M rc.w.. y...r
Ta Burial ~ -s,r ' • S ~ _
_ 4 • ae• Ca !fe ~ al Park_ r« SaraeotaR__Florida
GAiE . waww, wr, q.t/ - WNEt/LL -=NAME A DtSS . snetr of • r e rq . err w q.w, fr.rl. i.r . - -
March 27 R 19~F~ W n T~'u .Nome 3731 Tuttle Ave. Sarasota, Fla. 33550
~ - SIGNATURE ° - ~!/Geu o• e~tcfrtto at eeL/sra.e t`~
'
rse Tw ~
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A CERTIFIED COPT' MUST CARRY`1'N„ E EMBOSSED SEAL OF THE RRGtSt•RA.R OF `7E•TAL S?'ATICTICS.
I hereby certify that this is a true and correct copy ~k a ~P~ttfirate
on file in the office of the Lot-.al Registrar of ~itsl St:ar.Lstics of the
Pinellas Count Healr_h Departure t, St. Petert;burg,, Fioritia.
Sept. 10, 1979 DepEtty I.Eti;:~l. Registrar
_..Q~~2~'7 s.~~~ ~~4