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HomeMy WebLinkAbout1769 ~ ~ ~ ~~~t , ' ~ * • . ~ ~ f * r I ~ . " ~ ~ : ``~.~:~rj , ,R . _ _~_~F . ~ . ~ , f _ . - . . tL~: \JJ . . _ . . ~ . _ _ . ~ J if ,a t~FFICE of VITAL STATISTICS , , , CERTIFIED COPY 1':~~ Dc)l?('t S i)IX~N _:r- :d1~ ~ St , ,t ~~',d~ ~ - . - - - - - - _ _ - - - - L;•C Tr,~ : C::~ r . :tiit Cou~rt r~: L"i5:L7i J.~...~..~...-- 2 S y C~/ - ,.y~.;; ; ~ ~ ~ ,r Uc1:•.t, i;le~k CEHf1FtCJ1TE OF DEATH `I'ocal : ~ ~ ~ow cne no. P~- FI.~RiDA j'- ~ oeceoE?n •s ~rru. ~+~aar? c.w z sc x i~ V. Keller ~~P -~r ti2nrY • 90pJ11 SECIJRITY MVMBER S~ AOE•LecEWWy ~A UNOER ~ YEM Sc UN[~R ~ har a wta of oE~n+rNown. u„ +wl September 20, 1989 349 Z4 4156 °"'~4 - a au E oc ~ttH Mo+rr~ oa ~vl t ewt??w~~ ~y rw ~x a~wo+~ cio~rry? S WA6 Of CEOfN i E VE:i u~ u S Augtls~ 02 1925 Ibngols~ I111t1o1s ~o~s~r»:~.r,.,, , ' • _ ~ ~ ea Ptl~cE oP DEAn+ fCn~ a+~r on.: M. rqb~tio~t on cNw ua~y sh wSWE cm ~~pn rt N.s k~) ud y t MO.'S~1U1L' il N+p~/eN O EfLOWp~GrN FS OOA ~~R Cl tiw~eq Nan~ E~~~ `:~O{f~ ~S{ro~ YE~S d p~ lAC.'1L1TV rW 1E (J nW t~fa~ntlOn. !A4 w~M NQ nnO~?J !tL Cfi ~OMMM, Oq 1OG41OH Or OE~O H 9e COINaTY OF DE At N 2808 Navajo Ave. Ft. Pier~e St. Lucie s, ~ vr~ 1aa U~CEOf/1i'a tlswt OCCUOAfoN tOp Kkln Oc euSlNESSAtlOUSrav n- ~ ~ v~ir ~ µ a~ 12 ~d~nvt?f9 sPauSE (x rwt o~+ Rwor~ ~wnei Paper Nanger ~rs~•~, t Painri Married Eileen La Pa e ~ , u'~ ~.a Pain er n9 Yn i~!~ u. c~s+o~n~ - su?~ ~~c oou?in ~ao anr, ~o~nv. oa ~ocio~o~n ue. sraE~ ~r+~ ~ ~"1~ Florida S~. L~ucie Ft. Pieree 28Q8 N~vajo Av~e. .:.;t , : f : i,: ; ~3~. IN91DE C~TY t3f LP COaE 1l MMIS OECEDE~fi Of 14[SPA~NIC OR Fi/UTUW ORK'JM9 15 fiACE MM~ kidhrt 10 O~CEDENi S EODU R~ON ^~y~edr T iwntst~Mar~tv ~~n.~ic~ 7~~orssw'•~. ~ we t$,+c+sr«w?ug+».ua c~1~9.~, ~~s. Yes 34981 s~.~rr- White aF~~ j +s 11arHER's w?ME (Ast ~orew. M~rNn sw~w+y ' i7F~7HEA'ENAM£lFn~MkR~l.Yf) Lra Keller Maud Haker j ~ ~o. r~o~w~?rs k~ (~o.r?r~a e~a ~~nei ~nonESS ~+a.pu n?r~e.. or ~ ftx,w ~wa~o+c a+r ~ ra.a sr«? za cod.~ ~ Eileen K~eller 2808 t~va ja Ave. Ft. Pierce FL 34981 ~r~.~ ~a' ~a. ~ T?+vo oF asAOSnqK ~ae. ~~o~mn r+~++a w~.w% c~.r~c e? ~ ioav~a+ - cRr p*o»~. sw. = 8ww C) Ger~tlia+ YI~r kan Scw ~ ~ r, o«~rQ, n ow?~so•~? Wyatting Cemetery ~ Wyaning, Illin~is z~a sawcluRE oF F~xrERAI sEpvICE ~1CENSEE op t+n ti~s6 Ntn~sgi t~a wwE M+o ~?ooaESS oR F~autr ,:}1=; ?~S[k~ ~StUCH Ib+t~c«~a.r) ~ rV~.C@3 f~~ 2184 F2.or.~da Mor uary Se ? ~p-" 1495 N.W. 17th Av~. , Miami, FL "33125 ~ :<<~<;~;.~f ~ . . i Z 'L2a. i0 N~I a tt~ W~OM~pp1 tNf01 r~ N M e~, dW A~s atd Ous ip t?t Qn IM bqt. ot KMU r11~+:t?!b -~wwtPiO~. in n1 apr"on dssv, c~r~~ ••~w m , : avalq at sW~O. r, ~ 1•_/_ ~ tN IiM. eW MO:~ ~nd Ous l01M eaw~Qd and m~rr+N at xa~~tl ~ '!i; ~ /y` aa.~ •ad i : wO M!', oN f !4h DAif SiGNED (A~a. Wc tr) tYc 110i1fi OF OfJ1TH 23k OATE SION~O MR. ~F 14) 23c ?10Uq OF DE AI H ~ 4~ ~ Z•? 9 6:45 P. w ~ M ~ t'ti E~ 23d.PR0lIOl1NCEDDEAD(AIO.O~NI t9tPRONOUNCE00EADfHc4:.i ~ ; i; E~ m. r++y+~ or ~rr~+cu+o ~vaaw ~ ar?+t~a nwr c~ar~~ r~yv. w r++~y ~ :s~ s~ ~ ~ Nio ADDRE9S OF GEFifiFIFA (PHYO~, MEO(tJ11 EXAMa~ER1($'P~ a+~J ~ t ~ Sanjio Wralia l~, 22i5 Nebraska Ave. ~1F2 Ft. Pi.eroe, Flori 34950 ~ ~ ~ ~s.. avg . 5 , ~ 989 ~ ~w ~ , ? 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VWIS iHEiiE A J0i lf 9Ui1(iERY ?S MEtft10NED tH VARf 1 a ~ EMtfA CUlO[IfON FOR MM1fIGt~?T W.tiS PEfiF0~i01E0 30b DATE Of StiFK3ERY (Mo. Def! ~ea.) • PflEG?dJWC.Y W Y14E P~4i ` 3 tJON~H3~ d YES t: NO i~~ SI R'10dA8LE MRNNER OF 3h OAiL QF tNJUAY 3?~. t WE OF 32c. tNJURY AT YMORK7 7M OESt~iME HOVV pUVAY OCCURHEO 10 2 2 S 31:~ ~ _ o~vH I~wra o~4: s..~ ~?~wm n.. a?+e, 5~:: w 9' 0 J A N 3 t P 1 2 : 0 5 ; . . t ~s. vuce oF nuuRV - ti nor,~.. w,,,. sa. coc~a~o?, ~so.« «w ~,+o« a w,.« ra««a. na~no.: c~n w ~ew~. ~,~.i .~t~ ; wwt. tacwrt. aec i3~xCM ~ ' j r, ~tLt: ~!!'{i~ .r ~ i i~.~, St2. ! ~ ~ :Z~~~ r ; G . e i %~.M Ee'~SbM) ~ ~ B~JGI( PAGi li.lCt~ ...~!t~i • ~ ~ ~ HtS fS A RTIF p RUE AND RECT PY Of T OFF{C RE .ON L~ N THIS OFFICE ~ ~ iS:F. 5t,~r ~ p ? ~:1,• ~ s~ q`'' ~ `r ~4 ! . , . .~y`~ ~ fi sY: tt. Rfl~ ` , ! ~ State Req~sttar ~ ~ - - ~ AQ~~ - ~j ~hY vcswN Of s.~nS QoCUarErn rs vaa~9~rfD 7v uW oo +~oT ~c,f.EPt ~ ~ Wf4f 1N~IS~a :7`tL6a9 Otv SfC.URtiv PAP£fl YYlih~ GOL~EQ BALKGRE~i1hD ~tNTI GOtO E~r$04SE0 G~!£~T ~ ~s' . ~ ~4~~~ ~iFK Fi~:f • ~ SEd1 OF THE STASE OF FL~~~F}/. AITFAAS+UM OR IIi~SuFf '•w~ ~.~RT~~.Cery..; O~v~+Rra4snor~xn~+.~o . .u+l R ~J-d~: " riM.M1~r~~TYt SC]n~ _ ~ _ ~ ~ ":r ~~~~..e..: " " '7e~ ~ ~ y-~-~~-~~ r ' ` - ~ ` + ~ / 0 • • ~ s ! ~ s - ~ _