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HomeMy WebLinkAbout09943 _ •.~ at~r ~~ ee 5~~~~JV I ,-~NG UI-lE / G~ ' °~c1, . ~TA1[ OF \ti'ISCOh~Ih ~ ;•t• :c!ti•c~,t : ~ Ht~t1N at.J : _C~-. SfR~'CES ~.,,, ~ N :~ !~E~+I~H S"~'+TE SEATH Ni :~.~~ ~~.c NU\~BfR ORIGINAL CERTIFICATE OF ~EATN ~ i f ~'ED ~.~ti`E ~' t ti1.d01r W~I I S[R --- Wf( Of DfA(a Monen Lo~ Yte- Lottie b. Krzem~.nsk~ '~ fe:r.ale , April_ 29: 1976 -- ..~• •, •.tyro a~rr :_ _• F~ 1;y la f 3 r~.~ar ~u-:er ,•. r.artt i.-:!.r c.~ Gar I'•AiE Mo~m Ccr Yeor (OUNT~ CF DEAiN--- ( - +--- ~' B!RTN , 11f~IlLP. ,5~~ e~.~vr.r~5 .r, ~,~ ~ ~~.. ~.. J•• -,~t~ie` Anrii 2~, 13q1 ~a. ~ta~ine . ., • , 1:~ i p •.~•t+ ~ i. .;l!~ E • • •.. •t.. •.~~,• ~.iwr;n.~ 1nt,~,eC,t~01 ~M;~SF~TRI CR OIMfR INS1ilUliOY NAME'-" ~ T-.---- - --- --~ W -._ . o~ i..ctn v~::.:a- (~m~ts ~~it ho ~ F,f~~v G trrer qd Nu~++Gt or oc on a . 3urlin~ton ,~ ~. Y~, t-~,,, i ,d ~~r_in~e$on ~_e^~orzaf ~o~pttal ~ ~. ~ c ~iN ?~ ! lE : ;~ A~.,, - ,,..tr~ ~ ~ ISU4W NNG SD'JUSI - - - JI A~~~. ~•.~ •nmaen hame~ o • . ~ U~~ ..~r'_.~rrr _•:crr~r~. ...~r~rcrned J ,I11irio~S ~9 V~A - - -- ~e ~ e ~~„rz ,;..;.~;~a !~- -- ---- ------ . . .o Ti •.) t~`.,Al C' f CPAT~~ N"~ .~ I~. o~ ~IC_•/ G..n~ .~ t^~t ci,A_n •~ J Lft ~r!•.U Ds BUSiryfSS OR ;~~DU:IRY ~ 321-~~-9E~~ ~4+~~ '~Seavstress ~,~~ com~~rcial . ,, S'Aik j;"'UNT~ 1~ :k , •~ :;a~.f ( !r ~ r~ or :a:t aG ~:::~FSS . .~~. a.~sresti nr Lm.of Gnv, - . .•. . ~ ~.•,. .-. •.:~•. 1_ .. ~,~p ~. .Y:.rt~.h .. ~. s~ ~f13COt1S1II ;~st Kenosha _ ? iar •_ i Mlri ~x1KPS t ui X r,-; i; K, ~ ~~~ ;%9i_Le~ion Dr. _ ..-.,i c ...•: E ; r t . ._ t . ~ ~ '. :h~i ~ ..: ' ~ N •.t7F 1 r.~ ~ .'.~i'e lcst Z•5 Valentine 'Nesole'~c i 16 CatherinP Skiba ~ °~ ::G :•a4T •.AYE ~•.. l •. _~;.iE cS - --- . ,:. ~ i D f1.~ ` t. .• v - .;. ~t ts ,.-- nr.c : F ~ f ~cF ^ ('lf R t4 U S AR•If:~ +u?fF S' Q ' ~'- ~ ~~ ~~ ~ ` . -o . •~ ~ ... N-r..r D:.~.. } ~tr.~t~: ~~ ~Yin~fred !~'erraro ' Tya~l Le~~on Dr.,'['Rin I.SKP.S~Yt1S•,53191 ,: -,.~ 5~,"~., ~~-•~„~. - ~ + cs:,~ CeaiH eaS:.. ~c. B~ [, _ '.. ~ -..'..~' °,• i ...~fcr =. B ~. . '- ~ - .~ -' - - - - ~ - --~rafi!N1 ~- ~ -. . ~ ..~s. ~/ A~y, A . n .. ~te fr..s~ t y~. ~.~~ (. ! l~ `f t• ~.~-s~ / ~.•~ ~~, L it'~ r-~ / ! Ei~ .ti- • -.:.~ ~ r •o - t • ~ ~ ' - -- ---- - - - -- - f 1 .'. J -~ ~. .' ,~~~~~ ~:° ° _ ~,:,. • ~. _ `~t_' `-f.C'.~,j.~-~'' ~.~ =~-- ~= "' ~ - - - ----- -- ~ --- - a ..-ar-•ria,t ..e,c.c... c v : _._ __' =F ~ t. ~ ' . . ._ • i. . . ~ .. r . . . . . . _ ' 'r a. . . . r ~ .. • ~ .1 :DSI Spe: ~ W!M AYtO-ff fIMDNl6f CONS1DpE0 I, '.• ~•.~.'~~ L ~ .~ ,~ IN OE1fWINUlO CAI.S( OI OEAtMt ~ ' . . ~ ~t9~ Vts /X~~•~ ,,~. . ~r. ~_ ho ~ ' :-r- :f4i ~; ~!f ~F . _ •^ . . ~~•-. T w.._, Iti .. ....=r . .. ' - ~. ..r •~- • , .r. • "..•r i o• ~~..•t u, ntm IB; ' ~- c~ , ~:F ~ .. ar . ' 2 ' . p _ , . . ;'f ~.. . • ~ - - - - ~ --- ---- I .V • _:I AT l~ ,DY •G: • ~ ~,~.I N .- { ... i ..• . . , F• ... .. • . C T ~'_. t~ _ I .;~ St 'f t.p ' V ~ Q . ~ ~ ec ~ NO ! ' i 2^.t. _„ . ~, . ~ i u' f -c ... . . . . .. v. . , . , , • . , ._ ~ s A . , ..: ~ s. : i , . l - r i; : f b~ I•.F ~ ~ i Ain n; .'~o~ED a~ ilv ~'oc~. c~ i1:e • ar. .. •' .. t. . E ' ~ 't•{k :fatH n:~.' .^nt. •9. To The Dest . . . r.,~ `~ ~~ -1 I, ~ • ~•~, i ~.f •:~ r,.... el~~. D~~ - Z_ : . '• ir,m.~/~1~~f• /i.. /: ~~ , ,.li. ~1Jif-~ l~ r ~~j ..~tr'~~. i'!s / ~~/ i . r`. 1~/~ ~ f~~ Tc !n.;n~se~. Statt~l l/~-~ . l~ ~ ! / J ~~ ~ ~ 2' _ ~ ~~ 2 • ~ f ~~ ~ .. . _ ., t~" ~. o n'•.E- ~~ ~ - .. / .. ~~ . . .. ... .. ~ . .... .: . u: ir~ CfFD - . . . . . ~ c . . . • • . - . . •~ .. C o. r~~r ~ov~ Q ., ~r- _,,r. . . . • <• - V " .. ~~. M ~ ''.T ~c ~~;'f ~..• ... • . . [~ .:.' c: ; ~' t :7 ~ - - - ' t-. ~.-~n i •.FD Y-:tn L~i Yeer W ' r f ~ +~ ~ ~ s /(~~ ~L-,L '• . t"RU~ .~F?:.h@T` :T u I ~ I`ll 1 7~ ~ ---.-~, :-~ L4~ . _(: ~-~- . + •• • -----.~~- ----- p _29. 9 . ., ~ ,'_ << . _ . . . . , . :f,. r~ -,, ;25 i:. Jefferson :~t. ''.ur:inrton :Jisconsin 53105 ~ x e~ ~ e~ - - ~• ~.. 'e:r ~ .~ •. . .. ,.. ~c . . , r~ - -- ---- - ,~~ - • .:r ;,y,.~.t -- ~..;,,,,, ( ~ueen Qf rieave:~ ?~i:?side, I22inois , _ ..~ i ~~~ :.. a . a: .. ; ., .,n •,. ,~,T• •.~~n. .. ..: .....~ ,.,. .,.._.., ...... ..: : . .. , ., , ,;,. ~ - ~.;.. ----__ Io m 1,,'.:ay.l, 1975 ~~Cs.:~an ~uneralT~"^ape~l, 62~ LePi~n Dr., T~rir~Lakes~~:is 5 1`i1 . ~.~.ra~: :i`SfA .'ahr~Rr ~ ,~n ~ .;a -,~t-~ _ I_ctF ~Fj(.±4~P.t,~z~oeo~itnr . ' ( -- ~( Gcr vrar ~ ~ti~ ~ ~ ~ , "" _ ~ - . _ / ` ' • ' _ " _ ~ _ _ ~ . f/~...~Ci~f/~.~Q~'f '~ ~ ~ /.~ I ~ee _ `~n_ ,l.. ~- ~Q STATF. OF i~IISCQNSINI c, ~~J NT Y OF RAC I NE ) ss. Came be#ore me, Thomas J. Reich~ neputy Registrar for the City of Burlington, ~t.~cine County, Wisconsin, duly appointed and known to me to be the identical person and j ~fficial named; Who hereby affirms and swears tha[ the above documenC is a true and ~~,~rrect eopy of the records as chey,exist in this office_for the registration of births, deaths and marriages. 51296'7 ' . • ~ ~~3f ~ ~.~': -~ Ps~ ~- l ~ - • ,. - - i : .;C- ~ ~;4 `:,: . . ., - < ,.~f. ~'~l'L u -,o~ :.~ `-, / _ ;~t~•~:- ~..+•1i_ ~ vi~~~~=~~'t'±' Deputy Se~tatrar /~ity of~Burlington ~- . ~ ~ ~.;~1':. i...._..i• .. ••~ O ~ . _ , p ~~'', •` , / ..H~,:~I11~,~~/ • _ ~ (/ `~~~r~N1`flHl~~~~' ,~ .'.~'~ ~.j ll~f° ~i''z"~" Subscribed and sworn-~CO bef~re me rhis .~~ ~y..-.•.;^'•.r~• j ~~ ~_ .~• '' \R:J:r~i~..fti/S~v~~~•,~ f ~ ~: `'t~=.•:~'_~!.': ~i'~' ,// i ~' • • . . 'i .; _ . ~?9r" day of ~ , t976. :~~~,r,'' ,) '•~~- '• ' :,: r_=_ _ .•~'A~~'~~~ "~ _ • ` ;~ ~:;.; r . . , ~ . _ ~ _~N~ S . •. ,~ ' ,,. . . ~, . ~;fC , . ~ _: ~ ~~ ~, ,~ ~;..i. a .~ • n- ~ " ' t ~ ~~ ' - _ . a `;~ ~' . ~ ~ ' •~ = s . _ C%~~_~ ~. - iP. : ; f ;~, ' . -. s : _ ;~ . =`~~`~;: t~.4 y ; ~ Z . . . , . ' , =..• cFr'~.~:'_.`- N~ta P lic State o '"~~ ~t : ' _ ~~~' ~ ~t . ' , f Wiscoasin : '-. `~". « : ,• ~;• . ,.. . "7 co ssion • .'~ .. -- ••"` ',' . y expires Jan. 9, i978 -;~ ~, . ~ "~j:~`.{ J~i3b~ - ~fR 346 PaGE VV ~ I ~~~. ' ~ ' : ..~~ ,ti1,: . „ , ... ~'•~ - ! ~:~.~tt~u~i ~ aooK _ ~ -