Death Certificate - Dearing, Wayne Mead_1/18/2012Local No
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INDIANA STATE DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
EDR No
CR7
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3247 WEST 650 SOUTH
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HIGH SCHOOL GRADUATE OR GED
MACY OLIVE DEARING
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❑ ves � t+o HOLDERS FUNERAL HOME OF GIBSON COUNIY, INC., 319 SOUTH MAIN STREET,
❑ Yes � No
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CHESTER
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SIGNATURE
SIGNATURE
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�9`+ ATTEMqN ESTATE: TTe Social Seanly u is Eevg reµ.erted hy Uds stae agercy in or0er M pursue respans2ddy. Disclosue is volunlary artl Nere xN Ee ra pena2y for reNSai.
NFU-20
(7/05) . - . �
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