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HomeMy WebLinkAbout2960~` 515933 0 T~ls De- co~~s a lex~l teE- _ ord •Aen properlr. ea~eut~d .na .fll 0• Pl~t~~ la P.r- ^~0~11t f11~. r ~ ~ s • P1~Iwlr •!tA ~~~- •~w~at ll~et f~t •r t~~•..fa.r Puner~l atr~ecer ^u~t fll• c~• e~r- titte~t• •-t• tl• 1 o e • 1 reatser.r •ftAle 7~ rour• •f- ter dut• or s.rer• ^~klas ~w~ df~p~~t- UO• •f eod~. 19~ fE6 -4 P~: ~ 32 ~~~ •~c F• cvkccn s~ ~uc~f ccuNrr.rt ~. . R06ER POITRAg ~ CLERK CIRCUtT CCUN1 -- R<<.rr., „I ; , , '-~.~~ 5-159;3~ n~T~ ~owRO o- Nu~TM CERTIFlCATE OF DEATH •unuu o- wTw~ ~rwn~mc~ F L O R I D A *~'wr~ Fi« ao BIRTN NO RCGItT11A1~•{ KO 37 , 1 MAC~ 0/ KATN GOD[ NO. L YWAL 11[f10[MC~I~~~ ~~ 1Asa /l~~M~waw~' Rr~wrWN~M+w~wl ~. OOUM711 ~. ST~Tt ~ COUIITII . Saint Lucie 66-Q25 Florida Saint Lucie !. C~TY. TOMIM. Wl LOGTiON t. ~S K~CE Ot O[ATN t. C~ri. TOMM.O~ LOCATION e. K 11E5~0(f~t[ iwsioc aTr u~~TSr INS~Df QTY UYIfSI Fort Pierce ,E:[B Mo^ ~ Fort Pierce :~c~~_ f. w~rE Of ~If wM i~ ~w~ihl. Iwt M-ttf ~1lrtM) UC~N ~. STII[ET AOOUESS NpSMT~I W1 ~sT~*~*~t. PiercQ Atemorial Hos ita 208 North 29th Street ------ - - _ P. _ _.. ----- ~ - - --.------~, -~----- ---. ...----------- ~ - - ~ ---~ -- ____ .. _ . ~ MAMt 0/ f~~~f Alidtt LMf ~. GAT[ XwN D~I YtY c~°trti`ru«s~.~.p JOEL J. MAXWELL ~T" January 20, 1970 S. SE7( ~ COIOA O~ AACE ~ MAAAIEO ~ MEYEA MAAwKD ^~ MT[ 0/ 11ATN ! a6E (/~ KM~ s u~ot~ ~ rw K urai ~ wes. fYflYt~Iq) YwW O~w Mwn X~+. Male White rnoo+rcn~ aw~cco 9/11/1915 . 54 ' I ~ Ip~. USy~I p~ni-ATqM (Cire tial ysMt /nt 100. KwDOi ~USwE55 W V+OUSTIIr 11. NII1Nh11CE (Si~ft M/ntyA cw~W/1 12 t~iliq C~ ~W1T CO~wt~t1 Irriy ~wt N ~~uM tik. ~~ 1/-etvNl - Salesman Automobile Georc~ia [1SA 17. ~A?N[A'S MAMC 1{. YOTN(A'3 YA1p(M IMYE Charlie W. Maxwell , Annie Shaw ~c socu- sccu^~Tr w n IN/OM~AMT~ MOMATY~t wu.~a ~ Y reet ~47-03-5315 Jennv Lind htaxwell Fort Pierce, Florida l~ C~YK ~/ O~ATN ~E~ft- Ml1 M~t tutlt Ot- l~~t ~r (~3. (Gl. ~~~ lt).) ~ IMTUVAL HTW[CN a 01KET /1M0 D[ATM -~II? 1 0[ATM M~S UUYO ~Y- C ~y- ~Mtl[01ATE CAIISE (~) _Y~f -~ - _ - - . //`y G~~Kiw. i/~~I. puE TO N) _1_ .- _.~t 1~s . ~ 1~ . _ r-' r~~r~ ~t r I~ '". -- - ~Dere t~~r~il. s[wy Ut rdtr- ~ TO (tl fpy p~u fW. S -AAT 11 Ot1t11 SK-~flWf CAMOIi~ / 7K TO O(~TM MR~ Mu]~Y TO TM[ 1E~r~MI DIftAS[ C0~~1~00 GNE1~ M/Mf 1(~1 .1~. M~S AUTOK7 lEIIiORMED~ L/G 7~~ ~ '~ ^'~.~ --- ~~-~ ~ , 7CS ^ ~ l~ /'~~ = p~ ~rn~~~b~ `%~~ ~ oESt~~K Mow wu~r ottus~t[D (F:wta ~rarr N~Ur~/ tw Plrt I w Prt !I yYr~ /1.) ~ ACdOfAT K~OE MOYK~OC Y ^ ^ ^ ~ IOc vr[ Os Ifwr U/~wf-. (Ht. Yto ~ Wu~r •. ~. S ~-'~• i 2Q/ pUWY OCCURIIED mt h~tE O! uUUll~ tt. ~.. fw r rwt 4nt. I~/ C~T~. TOwN. W1 IOCAi~OM OOUMTI ST~TE 1IfNK[ AT ~ 10T MIMII( ~ N~#, IKtM~, M~lM, ~~lt Efr./., tf[.) M~OAK ~T N011K ,r Q~` ,/ ~/i 21 I ~tand~d ~h~ d~c~~s~d ~m ~a7 ~ ~ ~ ~ ~o ~~:~ ~ ~` `y ~nd bat w~ hI~ ~fi~~ on ~ r~ d ! ` W~tA occund ~f ft,~~r,_,~~m on tM d~f~ ~~~td ~Aw~: ~ntl to tM Mst o/ m~ ino~Nd/~. l~om ~A~ uu~u ~t~t~d. A ~] I t~\• jj~ ~IaMATYl1t ~ (I M II7It1 ~ v u~ AODRESS ,/) ~. ~T~ ~'~O •f• LO 0• /i7 • ~ ~ ~ ~ ~~~ ~~ / / CO~D~~t• a /l ~ . .eerr•te. 27. wws.-.ucr~ld~. t36 wrE ik ti~wco~u~[TtAro~t~tr•to~r 231 ~ocwTq~IC~cj.tMrw.r~~) (S[.r~i B ria~~~n~ 1/22/1970 Ft. Pierce Cemetery Fort Pierce, Florida Y.S.~A-2 2~ f~i R~ p~ECT0115SK.N~TYIIE ya~e~s~uneral I~O~~TE11[CG.~TLOCALIlE6. ~~. GKT11A11'SS~GMJITYRE Rs~.lY66 ~.e~~!~a~ Ft. Pierce, fFla~. Jan~x'v 22,1970 ~~~~~ ~' ~P• I hereby aertify thls to be t true and cotrect copy of th~ local .~- ,-'`' Registrars record on file in the St. Lucie County H~alth Oepart- .. . ,_ `~ msnt at For1 Pierce, Flotide. "' ~ •,,t: (VNun'u~g: Not valid unlesa raised seal of the St. luci~ ~ ' _ ''`' ~ cow,,y rfeai~h a~n~,r ~: .~f~xed.~ . -:.'~ . . . ,-~. . ~ ;,• ~_ , N. D. MIItER, JVI. D. , ' t, ;; • ,~• _ , County Hsalth Officer •~ Lou! Rsyistrar '. .~:' ~l; ~ ~` ' ~ '' '`~ ,:.~ls ~~ • - '~~ . .- , , 7~ . =:%~~ . p~ Deputy Local kegistrar ~ ~t~~t, ~ =i- ao~c~~~ PacE2~J~ ; . . ~ ___ ,~.~~:~~~s`sr . - ::~ _ ~~: --