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HomeMy WebLinkAbout1436eu i26 f) C/TY OF TRF.NTON LNV1.1/UN UF Ilh'AL'I'!I R00111214 CITY NALL PIIONF. (609) 9R9-,~236 "1'l~is is to certi~y that llie ~ollouring is a lri~e copy ~~ja record ~iled in this departn:e»t. I~tP oj issue 1{'ARNING: Do not occept this copy unless the raised seal of the ~) 1~ ' ~ ~~:~ REGISTItAR uI~ t~~r:s~. tiraTl~T~c.~ NEM1 JEIlSEV S?ATE DE-Ap1YENT OF NEALTH CERTIFICATE OF ~EATH •~'~t I. NI1ME OF pECEA5E0 iwp/ - pt~Nl fl~a/ 2. ~ATE Of DEATN ~ ~ --- ]a -IACE Of OEATN (Gty ar 7ownL Co~nty ~a. iMsrfenoe INe. r+d St.) ~~~n Twn ~~S,o~~E T~E~troN t~1~~e~--~_ - ~~ ~'oc~ ~ +~' . . ~~.Z'n~- ~NSNiP 5~. Nrne of`Ib~piw or MaiwMaen (t/ t eitMr. ~nre No. ad S~I ~. h ~0. Suu 4. Im~de Car lrm,s w ~~- . ~ ', ~--r.s-~i~ tY~g N , o~ ~,-., ~ ~ 0 ~ se, u~ w~~+s+~wam. a~.a oo.. eo~ a~~w sua~s ~.. w. oe«ara ...~ ~ us wN,.r ~e. w. x~ a+~ 0 00~ ~b u+wa.~~ t o w..s a~d wao..a n-r..- «K.. w....e o.~.. F.~: u .1 ~- ~. ~sniw~ ---- o L Sea~f~~ O OUw. Dau o1 B+tl~ ~~~~ ~~Q S~nar~d t O Q .. I O Yn ~y No To: ~ Iye lsu S+d+d~y t tw Under "1" Ye~ l te. Unde. "1" Day ---- roN~H owvs wu~~s I YINVT[S ~-~-,~ r~. E tqo ~~2 t~5 ~-~ --- ~ ------ ~z.. e.u~a+~ tsus~ « co..~y,~ vr~ ~~e. cu~ a.~n.~ co~.+w ~Z s~..~+w sw~~ t~~ w~i.. ~~ w~> >~_ so~.a s.w~M ~~e.. ~ -~~` -~t ~ ~ ~ . ~. ~ ~s . A . ~~~ -~ ~ zy. ~s n,a. o~.. rw..~ ~s. Ea~ a~ o~.;~,,, d ouw aoK:h~ ~~. ~•~+a ~ae~.+~ a iH~ E~o~,~ - --- ~ w~»w o oa~..~~ o w».w n~ o ~w~ - ~~ti ls ~1 l . a saa~ o c~e.~ o c~.~ .~ ~iJ Fl ~'~: ~J ~ ~ IL 5 w r.wawtE o.. 1 e. Uw~1 pcc~p~aon (Krd o/ work dorK ewat ol ' 19. Kmd o! Buar~eu w~~,~--.~--r• ~~ ~~ ~ `~T, ~ ~ L~h •.~~en H r'e-t•" `~d) ~^'`/ _ _ I ?~ ~ ~ O"7.J ~ ~ ~O • • - - - - ~ ~ i ~f ~' ( ~~ I~C.J~ ~ ~ ~''~ti ~ ~~a7'E.. 1~1~e l~, ~ N4~[ 3~ ~E pF FATH~1 (frit (M~ddN~ ~lnt~ ' ?`YAIDEN NAME Oi MOTiER IFwstl IM~dd~el IUstl i ' . ' .~l :ylrkw) '.~1 . 1 T'_+J A.~ ~'c . ~=~ lY~ l"~ 1 E ~S~ (., F'~+N1C' ____ t~?t Nrrrof In1awiant ~ 21p. R~In~onM~p 2tc Nu.nbe. and Street 7td. G,iyj` io.n ?I• 4au -----Z~~~'~•~~~J~~~4~,~rti1Jl~5i~~t~ ~lit'.~r.SD_~' ~-.1~',r,.~lafi«t ~- ~ c~usE 2b. D,ow~tm O Reww.~1 ~2D~. N~me ot Cernnary Ge~wr~ ~ Yh. Gt~ « Tw.n ~= ?Ia. Sute dBu~r~ O O~Mr: 1 - ~ '~o a~.~~ ' ~ 4. ft-7 ~ ~,(r_~,K1 K~t-.S ~~~' `~, f -...f :_1~ ~L ~'-,1 ~,,~P. IJ... . ~ v~ wcE Os --- ~. ?3t N~we ~nd Add~ep d FwiaN Iloe~t ~ ~? S.ooa~Iw~l f M D+ecbr 23t NJ_ Lran~e No. wCC~OEMT ~ V ~St~l"1 ~~V ~l~J ~• ~ . ~ . \ , ~...J _ _r~' l . ~~.^~r jv . a ~ ~ ;~"t"Shwl i l. ; o-v~ ~b- ,..,r ~ z.a. wu ..«,.~a er . : ~~SS~:,~- - - - ~, .S o~ ~~~~~ ~.~ ~/ _ ~ --C _ ~ _~-~; ~a . ~ . .~.... ~ ?Sa w« w~ur~ w e.nr~- !h wnw.~ r+.a O wa e...~ o~. ?Sb~ r+r w.t~, .~..+ .. . ~ w..~.. ~... w w~......o ~.r.:~.., 1 C ~ Dr McClosk ~~- ~~C~~~ I~~ ' y , Packard Ave. l ~_ _ ____ ~ ~ 2380 Huntingdon Valley, PA 19006 'S`OaiS''i°A ~' "°"~°' ~b ^°"°"""dOs° . ~ ~ ~ - ~/ _ c .h,,. ~y+, o,,,~ `I ~~ ~i ~~ 1JL i / ' ~' _ <``) -- --- ?7a -ART 1 le+medru Cauw . (Enter on1Y one e~uu Y!~ Irr 1a l+). p1. and kl. - ~ntnrar oen.een onuc arw de~tn , ~CI.=:C~/'ZL 1 4JQ lnc' l~t,tt l L4'.~c [c~ _ ~S[.!'u-"Z~~- - -- - - OtKbOrM / I• ~, ~ ----_"__'__.. ' ' ._ ____ p. ~Cl~~ j C~l ~C~~J . `L'l~(r~y(~~ ~ OYrwq , b1 ~ --- - - -- --- ---- -- - - t ~- 'o ~ ,LJ~yQ~s~~Lt<C-/L~LCIL 5 MRT 11 .flshp si/ufKSnleoidnom - eoMAam oonu~butr~/ w OeatA bw rot rt4tM to esufe r+ ~ART 1 ?S W» Aueopy ?9_ Kas cax ~ehrrM w MM,tM ~1~" i 1«medi E.amrie.o._CaonnT ~ c~Y7s :, y~ts cl~ ~,~CC.s/ a~:vocfi ~~ ~a:'.[~.tih_Yu~.+ d~oo~ o~rn o,.o n Y., r~ ~w 30. Oes~A dut b O Fbnrc4t 31a Otw~6e Ma M~ur~ occwied ~Ib Wu ol In~u.y -- -- 31t 1bw M ~ ~r O ~-ueem O tlnde. In.est~t~on O Su.nde O OeM. - ~ :6 ~r ..:: o~ O frm O ~~~wr ~~ J`#~ P~Gf 1434 ~Id Iryury ~f Wort 3~~. R~ce o~ ~~ywy Q Ofl~ae Su~Mry ~ll loca/~on (No. snd 5~.1- --T 3t9 G~r a Town Ci YM O Ib O lbwi! O Strttt ^ OthN ~ ---' - - . _ 31 n. S[.te __~ -~~ ~_~~~~.~~ ' 80 63'7