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Home My WebLink About20080213NUM PGS ~ DOC TAX CK# FEES S~ PD CK# CHG r0 ACCT#~ZSL~`~ RET REES~~:7~---77.-OASH R.0.0. CK#--~ /N RECD 1~/2/iny~rl ~+ y,~'~!/i~Dl~r /~C RETURN ~/l/~~~n '~'_S'.~riy~ts~ pG~ /7la,J~i:~fr /IrEG890,2- 005!3 ~i~~~m~i~iiii~uui _ 3~- 7-lz . "aC~fP .r ,~1 /~1 ~~ .~,~1~'ARE ADAMS COUNTY NE FILED INST. NO...~aQa,B,,,~,Q,213 Date ~ ' - s Time~~rt ~~~.~~ REGISTER OF DEEDS STATE OF NEBRASKA _ WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD ON FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES, VITAL RECORDS OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS. F ISSUANCE - -~`'`~ DATE O STANLEY: COOPER g Bi ASSIST.flIV7' S~i"AsT~ REGISTRAR SAM I) ~ ~OO~ - DfPARTMENT~OF;M~>gL~KAND LINCOLN, NEBRASKA ~ NUMAN SERVICES " ~; , s . { i' - STATE OF NEBRASKA - DEPARTMENT OF HEALTH ~ ~ ~~ . BUREAU OF VITAL STATISTICS ~ ~ ~- ~ ~ :: ~ 8 y 9 G CERTIFICATE OF DEATfi1 ;;' ~:;'r.•"., 1, DECEDENT • NAME FIRST MIDDLE LAST 2. SEX 3. DATE OF'CEATH? ,lbrrrr On, veaP~ MANGERS Male Auqusts29,1994 ~. ANO STATE OF BIRTH M natA U SA. rams Fosneyl Ss. AGE - Last BinMay UNDER 1 YEAR UNDEP. t DAV 6. DATE OF BIR: H lAbrl/r..by Ysr/ (Yrs.l [`~~~}~~~/ 80 50. MOS. I GAYS Sc. HOURS' MWS ~ February 27, 1914 - 7. L SECURTIY N'~U/ABE Be. PLACE nF DEATH . 5G8~-44-6314 --- HosPrTA~ X~ Inuaoen oTHEa ^ w,~Har.ra 6b. FACM-ITV-Name lXrat.nsEbau~gw steetaM nunrAr) r ^ ER CW~aYanl ^ RssWerKe Mary Lanning Memorial Hospital 1 ^ ~ ^ p1e,l~• - Bc. CITY. TOWN OR LOCATION GF DEATH ~~ ~--~ Bd. INSIDE CITY LIMITS Be. CUUNTY OF DEAM Hastings ~ Yq~ ~,o ^ Adams . 19:.. NE iIDENCE-STATE ; Sb COUNTY 9c. C.ITY.TOWN OR LOCATION 7J. STREET AND NUMBER /kKNdYgZp CatleJ 9e INSIDE CITYIMTS Nebraska !Adams Roseland liox 112 Yaa~ Na - tD.:tACE - leg, lVla!e. BIaLM. MKmrM Ylglan it. ANCESTRY leg ttWn. MeaKan, GemuN. ettl ~7C-l MJ,'iPoED ^ YN.WWED 13 NAME OF SPOUSE lAaye rye main M.rol elcllSoecayl (' dyl l~_JJ ~`erman ~ V NEVF_R DIVORCED rene Bonifas White A _ 14. USUAL GI.CUPATgN (rree Lrnf!q)aVnF L.'av!AaajT muc! t4b KIND OF BUSINESS INDUSTRY 15. EDUCATION ISPaLIW M'tiy llglM.W CprVAlMe( d aark.nq a!a Ivan Y rae.a~q "r>armer __ '~ /-' ~ Agricultural -~ ~ ~ I 64veaarYaSacur0a~y10-12i Cdloga11aa5•I lJO te. FATHER-T1AMF. Fe'ST MIDDLE 1A57 77. MOTHER FIRST MIDDLE MAIDEN SURNAME Frank Man ers Louise {ioxmeier 78 WAS DECEASED EVER W Ub' ARMED FORCE57 19a INFORMANT-NAME - (Vac. ro d W..1 IM yes. gR wr oral r/nec d aa~-acaa) _ rene Man ers -Wife _ 79P eJFOHMIYT MAA.ING ADDRESS !STREET OR R.FD NO.CRY OR TOWN. ST0.TE. ZIP1 Box 112 RosAland,NE 68973 w. E4BALMER - SIGMA E {LICENSE tJ0 2ta. METHOD OF DY.f::SITKNJ 2t b. DATE Ztc CEMETERY OR CREMATORY ~ NAME o ~~~~-~-~ °~.-~,-~.. ~s~`4//,~848 Ban.+ ^Ramoral Sept O1, 1994 I Assumption Cemetery __ 22a F VI/EAAL HOME -NAME 21C CEMETERY OR CRk4:A'lORY LOCATION CI tV OR TOYJII STATE Livingston-Butler-Vollant~ ^G"""'"' ^°o'""" Roseland, NE 22b. FUNERAL HOME ADORE£~ IST aEET OR pF.U. NO.. f.'17Y Ga TOWN. STA7E.2w1 -~~- 1225 !d. .llla Hasiin 2aE 68901 ~ 2J. MME SE ITER ONLY LINE CAU ~R LME F(1fi :al Ibl. ANU Ic)I ~- I Ir+e.+N bataeen seal arW xsm - PMT ` I ~' (af TO. AS A SEOUEI:CE OF aaerval baineaa afalel ehf oeam (] 1 Ib! 1 - ~ _______.._ ---- ~ yye.~al p,ASaan aRyy rq seam WETO.O /./n~A C~~O)NS/E~O-fUJ-F. EOF T OTHER SIGNIFICANT CONDITgNS - Cpleenl5 CLRUiblAng b me loam but nd relalae PART r. ^F cEMKE WAS TF:[RE A N AUTOPS ~ i 25. WAS CASE REFERRED TO MEDICAL PAR - PREGNANCY W THE PAST 3 MONTHS> ~ EXAMINER OR CORONER> tt I IA?a"J.Sa! YM ^ No ^ I Yed ~Nt!~ C7g Ya5 n Wj 2M 26b DATE Of INJURY lMU.. DBY. Yr./ 26: HOUR (`F MJURY 261. DES=PoBF NOW MV,)URY OCCURReG ^ ALLWNa D uaeewmnao _ M Suxde ~ PerMaq 26e ~.J.;L'RV AT WO{M 2Ei f>tAC~ pF, INJURY - ~~-/~,,.1,,,~~~1,,,v~~....pppn~~~a. fem+. ,ace1 feceroy~FSg. LOCATKx! STREET OA P..F ~. 40. C:T OA TCY: T: STATE La Wm1 l I C )1 g. a HomKda mve,agaaa, Ves ^ 1b ^ ~ .~.~.-.__. I . Ina GATE OF DEATH )Ab Day rel ~+28a DATE SIGNED /MO pay Y.. >Bb. TIME OF DEATH J;1 ~gy~-gust 29, 1994 y~~ M _ __ ___ -~ 47'i 2Jb DATE SIGNED !AM LUV Yr l 2JC T;ME OF DEATH ~ i T 2ec PRONOUNCED DEAD !Ab Day. Y / 270. PROIVOUIYI;ED GEAR (!bYXI ~ S ' ~ ~ eptemb 9 3:25 M ~ ~ M D _ .-~ -._._~~ ere To a.e ~ nn , e Place arw v Zae. On me batis a a.aminalgn an0~a investgatwn, n my aPlnon OeeN ucturrod m ca1Aalc / v a Ire ems. ea:a ane dale arsi sue b the cause!sl atabe. , L ISgnaers aM T,aei! T ~ , 24 DNi T0:1AC(-,p USE COHIRIBU E 7U HE DEATH? 3 a HAS ORGAN OH TISSUE DONATION BE _ EN CONSIDEI~O> ~JD.b WAS CONSENT GRANTED? IJ~YES ^ NU ^ UNKNOWN ^ YES © NO i ^ YES ~ NO J1 NAME ANO ADDRESS OF CERTIFIEa IPHVSICIAN,CORONERS PHYSICWN OR COUNTY ATTORNEVI rTYPa ar Psml -_-_~ Dr. Robert_M__as_tin 1021 West 12th, Hastings, NE 68901 ~ ~ REGSTRM JJD DATE FILED BY REGISTRM ~.~.. ~ r_ _ ~ SEP 7 v 4 ~NDF~~ ON: The North Sixty-four (64) acres of the Southeast Quarter (SE1/4) and the South Half (S 2) of the Northeast Quarter (NE1/4), all in Section Thirty-six (36), Township Seven (7);North, Range Twelve (12), West of the 6th P.M., Adams County, Nebraska.