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<br />UATC RCG157CItED ^Y STATE REGISTRAR
<br />STATE OF COLORADO ~ -
<br />• ~ CERTIFICATE OF DEATH v~ ~~
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<br />I:ATt0L1a 1~J:lIc1 A'.l1CF: P+l April 9
<br />1975
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<br />R'(E7•,- .a. •a •.a• a•+ •o <LF - • 0<IF Df prglrl r.o-. ,. o.• CDUNLY Of OEALI
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<br />Colorado ~ ~ P~UO.FD D~vURC[D r•. a...
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<br />Colo Rio Blanco ldeel:er no South on S:I~:;a
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<br />Arthur Amick ~~~yrtle Clheeler
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<br />NFOX.rnNt .N<uE iCLALION iO DECf <SiU NAIL Ir.L <DUflE15 •.ffr R+•r r. .. •.rG a•r
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<br />late of Colorado ~
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<br />'ounty of `RIO BLANCO
<br />j _~_ $ll_E W. MANTLE _ ___ ___, Local Rrgistrar of Vital Statistics fot the
<br />_ COUNTY_ Dt _RIO BLANCO ______
<br />(City, To~,vn, or County)
<br />State of Colorado, do hereby cuti (y ihaC the above is a full, true, and correct copy of t11e record of death of
<br />__NAROLD EWIN AMICK__ in my cuetody, an<I aow on file in my office.
<br />-- (Name)
<br />~IVCn lender my hand and seal this _- 3}Sj -._-_ day o[ _ DECEMBER _.__.-____ ___-____-_ ly ~~?
<br />SUE W`MANTLE BY_C~Z~'~~~~C~~-~_~~.-,o~~EPUTY (~1,,~)
<br />).gcal lirgistrJr of Vial Statc.ticN C
<br />Registration District No.194 RIO BLANCO ____ County, CaloraLlo I
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