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CERTIFICATE OF DEATH
FLORIDA ~„lr,lt„o- 113
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""E oEClOtw1~11utE E1tEr rloolE t11st sE, wle u 0t11M /r.. r.J
Of MINI
ry.r:w1+E E• JOHN 11111N VANDER N I
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IIIUwl.ELOEHCE • NoZZand U.S.A. E0. ;tarried 11. Eva In??acm
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1~ Re~notxtZ-Buriat I•.KirkZand Cemete 1.~ Z '
`(s't"`•'' ""EtAt1D"E 3015 Okeechobee Road
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i1~ DATE SIGNED /r... ATr. l•- Oi pEA N MTt 61611ED (r.. A•T. r•J IQlt O. OEIUM
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;~•,0,1~ V1 b.. Februar 27 1979-
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1 Hereby certitY this to be a true end correct SPY ~ the
Registrar's record on file in the St. Lucie County Heshh DMA' _ _
i
rnent at Fort P erce. Florida. _
(11Yarl~.n~. Not valid unless raised seal of the St. loch
County Health Department is affixed.) 1 ;
N O tillllcR M. rJ. ~ ~;j'~ - -
~p,,.,ty t,e, h Ott.• er Al local Registrar -r - -
Deputy LpCal Rea~rfrwr
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` 4'70059
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FILED 4?t. . -:CEO
ST.IUC~~ - rlA.
REC'~'c URT
IIR DEC 19 3 is Pa '~9
P aoo~ 322 PacE 1374