HomeMy WebLinkAbout1206 . 4919'4
• E / , ~.cE~ E Er E~.eI'~ E c v~ uc.r~ E M ~ i
.rr MIdEE(RR Dn~IIrRE d MMs 11oor w~ eif rrrM
-NAME rr.fe rreae .A r
• t _ Laub Emale ~ Aril 25 1971
RACE »r :w. •r.n +«o.•» AGE - r••t ~«eN r rt•• u•ote , OAtE CiE RIRM ..orw., o•,• CCIUNTY CM OEATN .
eK . •Iet MtlwO•, r,1.00+ wof O•H w]Y.f nw• MaOr
• ~ wZ~_ k Oct 5 8 4 t. Oakland
t`( V 4 L A , ~p
TaNI(N$HIP Uf ~f ATH •..uoe crr. rrwrx AE OR OflEq E+e3 - ~ w rror er?wte, c¦.t ?wer .r r+wee r
wcrer .t• a r•D
~ ~ Madison Hei the ~ ,r_yes 25151 Dequindre -
Sutf CiE W1M a »or v e • ...•rr C1ttIEN OF wNAt COUNTRY ~ MftEEE{O. NEVER MARbEO. `,SURVTVROCi St+py3E r w .w, or+t .uwt.r r••p ~
corrrrxr . S - ~ W E10YIE0. OiVORCEQ r teecre r d .
_ NtO..rp .Ohio t U. marrieQQ Zi_e ler
.~.rP ~ a•rw SOC~AI SECUtnv NJANEf --USUAL CICCUTATgN a+. er•e w .reset owe OW+r•G .oft W rlt•O OE MISINES3 OR I?~USSRY
occusao w ~ trotawfi uK, ae» u etnao +
~~,'a'~ ~t ~Y8 0617 _ _ Kni_ttin • mechanic Sweater_M~.
~'-Q3= ~
.D+•tarw•~ ~ES~DEN:E-S'AtE COUNtr CITY, VILLAGE OR T0INNSHID ! rr•erwctrcr~n S/REEt ~E
+ . wca• .tt a rrp+
~•.Mi hi an Oa>tland Madison Hei the ~ItE es It.25151 D uindre
tAT?KR -NOME attr wrppjt IAH MOEt1ER-A410EN NAME mote •wOOrt Wr
I+ Laub IL Emma aoy~_
It~NORMANt-NAME MftiM•E•r wODRE13 rtxur of t e o .q , on a ro.r+, fax, trr 4 V 071 -
It r Rosam n Laub I~25151 De uindre 55 Madison Hei the Mich
•ARt DEAtN wAS CAUSED [+r _ (E?rrfe Ortlr ONE G?USE rEf ItNE ECTE (s;. fs1. AND (cq wn.aw owgr •rr0 ot•ew
i
j - ~.re .x cwu / w ~ . /
+'tI ~a y E. ~.Q V a3 c lw... f~?'~' !mow
Efif'~' • r
- ~ . r • fr rv ~ 101 Q ~ /~i'•J j~ f ' V c ~_I~ -
+rC~•rr• ;•.rN o•, ' twt rc:. a •1 . GJ»f1oaM»(• J!_ _ T _
1r V, ..r Det T ~ .
:t'
~ - _ L _ _
.At+l :,THER SKsNMKANt C TiONS co»s..o»t ;o.w .o r. wt »o e1r .uu •.•w» •u* . ,o ~«SY tE YES vtn nro+wot cw-
_ ~ p(Q 11tS D• ~.0~ UNtNY IM Dttt.~MlMo (ANfE
ACC~M•+i St.~CIDE •rpMKrOE - ~A-tE bT W~•»
o•-~•
[t•~r~~-. Npw eNluRY OCCUfRED ~ t»x....rwt a +M,)~V.".:M e•n • o..•.t +.t~ +f +
I~ M ~tM
rN1Utr At WOft TtACE Ot M1Uf..r wpwr. ut~ uteee. •.c-,~.. , IOCAftON _ s+nt. o• o r o .•o • an oo ws.., ft.x •
fer: •et O. »O. i7•r K• MDG ,eK f.tC+r• •
EE+r i?Ir EM
CERtMrCAttON-- .a.•. o.. •t•t .o»nr o.. •.ro usr w• .w. »rt .rr•e w i r . oro rqt rrM M
oeArrr occuEao .r w.t race, w rwt
1w,fK+.?. 10 r - •r0•.ew M• ,tY - eoe ~+rout• O.R. •a0. q ME MN
. •...»oeo •-r L or ew.r+eot. Due
71t cr:eae: •.o•. ~96~ire T - ~ ~ ~EI+ ~ /~j7 t~/ tN ~y to nrt uwu s. frArp
CERTnICATION- MEO~CU EaAAUNE[t COEONER w •»t t•s s a .w .row o• w.n. rr• otc wr .•a etor•oVwcep oeAo
_ t.u.w..,o., r.y w:o• o. rw •».tt•K,.•o». ~,..».o-. / ~ +w w. .r.. wuo
_ Ot•r» OCCYMlC rrM P••r •»D DJr r0 rN !.~St~f, fr•rr~
CERTIFIER--NAME .r••e o/w~r(.~»•~ T~riAtuRE O'~7 M
C - - 1 ~ ~ ~ OtGae n AtE SIGNED ,+Ow~ _ I / r
MANNG AOORESS CEf3 rER~ ~ ~3swEEI q¦ • • o r.o a » ~ sax ;
:tt Csw ~ ~ '73 i
RURIAI, CREMAtpN• EEreOVAi C ftERr Ot CEEMATORY-NAME lOCA1TON CITY, VIIIAGE, OR COUMY sr•x
• snore . ~
o
TE ____gurial ' ~N QakvieY+t _ ~ Oak, Michigan
iFU RAL HOME- tpttr r. crr, rq.r. tt•,
Apri1~7P, tr971 ~„~~ramer ! q ~1•. fain Dawson, Mich 48017
. ~-O8 f L ECtO1I- S~Gr~1/'lNf pf DAtE ftCE1VED 01 tOCa EEGIfiW
° C ~f
~ 30nA,1 1 rs. ~ tH
a
A -
T.~ ~ fly 4.' .
' ; + - s
t ~
I y ~
f f r
1
{
•
R
_ 4919'4
I
4
r
19&0- TuL.g A• lo' lz
.~'E~~
~ • ` fEV t
ff''
BCOK~~ PA6E~U~
.