|
r " I W, f .,Ul IJA" ';V
<br /> 014M�'A A 0 AII&INIL,-,I
<br /> V 1,q-T05 1-11,11
<br /> mw.� , r ft 4 1"wi
<br /> Re"
<br /> a 0 1 MIA I F-1.I w: a I
<br /> N
<br /> .. .....jA.
<br /> TATE FILE NUMBER
<br /> CERTIFICATE OF DEATH
<br /> 2020
<br /> /I DECEDENTS NAME IFIMI.IMMIa.LSIR D 2 Mal 5E4. ixil1i. .I.3 DATE Of DEAT.daYenl
<br /> Earl L. HALE e November 5, 1993
<br /> 4 SOCIALSECUAIT" M AGE A I YE 5, URGE I DAY 5 DATE OF BIRTH IN.I.PLACIE 4.114niii.n.n.-'--In
<br /> NUMB 7; C
<br /> ER UNDER "IF IYonIR 0.1.YM4
<br /> . in� F IUS
<br /> OunIpJ
<br /> 522-28.0044 1 February 19, 19171 Deriver, Colorado
<br /> DEATH Win'"wlTanel
<br /> V.S.ARMED F04�ESH
<br /> N�FIZAL nalan,
<br /> 0 Y. W. I EAlOu'davin, ]GM I flWump Hem 0 Rwwdhn a OORN'IS.-I0
<br /> Md.FACILITY NAME(it nalmn,wllon.9)w wmer and nwadoaq ft.CITY.TOWN.OR LOCATION OF DEATH Ed COUNTY OF DEATH
<br /> Colorado Springs El Paso
<br /> IF—1-15fdiCQSTPY 1,MARITAL STATUS fal.." I. SPOUSE
<br /> IN-4 K
<br /> AD=.
<br /> Rancher Cattle Married Daisy Howells
<br /> 13ai R�ESIDENCI STATE �34.COUNTY CITY.TOWFLORLWA7IOM I
<br /> ITT Colorado I El Paso lorad-6-SprM gs— ar-
<br /> orniDrive
<br /> -Sprm 9
<br /> j.E,,CEDENrS EDUCATION Specify did,i'AH'
<br /> ..'V a.
<br /> .Rik 2) 1
<br /> INSIDE X ZIP MOE 14,NAS OECIUENT OF-I-
<br /> CITY IT'i-.=
<br /> LIMITS? EN INIFF
<br /> xy.. 80922 white
<br /> 0%0 IT "1 7
<br /> )FT—IIA—T.E.NAME Vine,ainid,Lav) "NAME 10 INFORMANT NAML And HILRIONINI di�Wd.
<br /> 10,MI
<br /> >,=,rale Bertha Mathews Bonnie M. Solberg Daughter
<br /> ffiS'T'OH! lVd.BALE IF ORPO&110N W.dCemelell Olv Ai all 20,LOCATION Cift,rinTinnn,SNII
<br /> CO...,.. OPemOelllOm&ab offisioaW
<br /> DD.nalnnn 00%1Nn(9d*,IIA— Memorial Gardens Cemetery, Colorado Springs, Colorado
<br /> RILBIGNAWREOFFURIERAILDIR! TOPICAPERSONACTRASASSUCH b.NAME ARE AJDDREI "21Inc.OF
<br /> 6irectors, I
<br /> 7C�7T Rwo?"'i�aM= Avenue ZIP,. 80903
<br /> Timothy golfs Colorado Springs, Colorado
<br /> 121.[MIE111.101 an
<br /> ��n`7
<br /> OFil"q";!W�Z'n INAS.�. HER MOTIFIEDi
<br /> ,a Yonln D.' I'M
<br /> 6. :45 Novenber 5 1993 1:45 A.;." No
<br /> TOSECOMMITEDONLTBVCENTIFYINaNYSICIAN TO 51 COMPLETED BY CORONER
<br /> 25 T*t nodal..a... pi Ind J.. 27.01 1b.bea.dia H.bell 0 in,AiMal.ft..d-di. M and/.,inn.ifiI.H.n.In na,Mi..d.:d...Inad 9
<br /> .milvariRninnin. annAiNdRand Pik-anddin,1.f...P&B).M nam-N&A at
<br /> S......R,Of
<br /> 211 DATE SIGNEDIMonIR Da .1 29 DATE SIGNED(Mann,Day.Veal
<br /> W.NAME.TITL E AND MAILING ADDRESS OF CER I if UIRUCORONER(TYPNiniaAll
<br /> Robert E. Winans, D.C., P.O. Box 1408, Monument, Colorado ZIP. 80132
<br /> 31.NAME OF ATTEND LNG PHYSICIAN IF OTHER THAN CERItFiERITailinni)
<br /> THE OF �INJURY AT 3kL DESCRIBE HOWINJURYOCOURRED
<br /> I URY
<br /> I
<br /> X. OF wEATH �d-OAT,01`= I'E'a T.,
<br /> '!!QwMUd.I 0 NNMI.O.� OF.. OM
<br /> 0 AsIdanl
<br /> 0 Suii,w. 0 Und.t.nin
<br /> Man.., I e.KACEOPINJURVIwainiahinn.Mr.W.M.0I U LOCATION 0i Frad HIPater W RiviB AM10 HundiIA CI MA SaFUB
<br /> Rimini,... I ft
<br /> M Ad
<br /> S,L IMMEDIATE CAUSE uall...11:NE U:EPER fidannij- a I i
<br /> LINNE FEAR:j:�2 inniv Eaddia 0"M(*4 CMRS,C W Rampina" ta"md" t
<br /> "d—Un
<br /> PART
<br /> IF) R I,
<br /> CONDITIONS DUETO RASA ONSE XL OF
<br /> IF ANY WHICH A K
<br /> GAVE RISE TO (b) W7
<br /> IMMEOLATECA
<br /> STATING THE DUETOORAUAL ..INNM IfFI.Nieneel
<br /> UNDERLYING
<br /> CAUSE iandiiinadi
<br /> LAST R) (0
<br /> THE R SI CON n nPART OARTIFiGNIFCAWbuis.0ION5-��b.�.nL,-b.1-1l.d.mlhWlnWmWlodlocaum F—A�
<br /> It P g-aco014 datY.Anail. WIN.
<br /> No
<br /> THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF THE OFFICIAL RECORD WHICH IS IN MY CUSTODY
<br /> DATE ISSUED k, 11�1111"V'
<br /> 1:5�LbA I�TRAI r
<br /> 0 8 1993
<br /> -Do-Aot-acccpt unless prepared b, g th.eDi
<br /> seal and signature of the Registrar. PENALTY BY LAW, Section 25-2-118, Colorado
<br /> '� ?fi, �,ll.. any vital statistics record. NOT VALID IF PHOTOCOPIED.
<br /> Statutes, 1982. if any person alien, uses, attempts to use or furnishes
<br />
|