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<br />- STATE OF COLORADO' -. STATE FILE NUMBER
<br />CEgTIFICATE-OF DEATH• = ~ - -
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<br />Thomas .Miller RASSRLL ~ I-I .- ~ Male ~~~Ouly 2, 1995
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<br />525-~6-9837 ,,' ~i~ "~ 01 •Y' ".° ;M'"•' May ~'9, ~~'f~37,, Clnyton, New Mexico
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<br />Fernando A. Riyeron MD 1224'- ..E31 be~~ , h`W of ina, ~Cplorado xua 80524
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<br />THIS IS TO CERTIFY THAT THIS IS'A TRUE'AND CORRECT COPY OF THE OFFICIAL RECORD WHICH IS' IN MY CUSTODY.
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<br />'nL~L"NIT DATE ISSUED QQ-
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<br />/4 _ -~- -- - - _, - ---~, - _ STATE REGISTRAR r Q,
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<br />~~;~ g2~~ ' Do not accept uNess prepared on security=paper with engraved border &splaying the Colorado state ~'`~~ „
<br />I Y seal and signature of the-Registrar -PENALTY BY=CAW; Section 25-2=118, Colorado Revised ~, v ~ '
<br />~~? ~ ~~~' S[atu[es, 1982, if any person alters, uses, attempts to use or furnishes to another for deceptive use any ~ )c S -,
<br />r ~~~~> vital statistics record. NOT VAW D IF,PHOT000PIED. ~ . - ~~ tooa tzret fi//rL~'tL * n
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