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Death Certificate - Hasenour, Robert O_11/1/2006VAfVDERBURGH COUNTY NEALTH` DEPARTMENT Room 127 Administration Buildin 0 0 9 4.O H 9- Civic Center Complex - One Nodhwes! Martin Luthe� King Jc Blvd. Evansville, lndiana 4 7708-7 828 CERTIFICATE OF DEATH Z�j i5 � e L• t L r I e(� / THAT qCCORDING TO THE RECORDS OF THE F'EFLTH DEPqqThlEhT yA��E ROBERT p, j{pg���� � DIEDIN VANDERBURGFi COUNTY INDIANAON SEPTEMgER 29 TIIdEpFD'cAih 09�13 P.M, rena 20�� �AARITALSTATUS �RRIED SEX�I'F AGE 59 WpImg socia� s=cuFi7v Pnce DATE OF B�RTN ��/12/1941 PlnCEO.^'pEAiN. ST• MARY'S HOSPITAL ?RIMFRy CnUSE OF DEqTF! GNEN VJqS �ANCER—CHpL,ANGIOSARCOMA aHYciqAP:ORCOROkER MARI( BROWNING, M.D. ?UTOPSVNO PU`C�OF�UFIALORREWOVA� ST BERNARD'S CATflOLIC CEMETFRy �uraeaa�N�t�e eTOA�FIILL FUNERAL �nn""ea NATf1RAL DISEASE HOME, FT.BRANCH,IN CERTI.9CAi E N�� y;;Ep DA7E OF BURIqL 10�03� ZOOO OA VOLUAI= SI; � pqGc OG001932 DATE ISSUED OS�1$�zOOl tJOT VqLID U�LESS SIGNED $ SEALED 4 , ��1� (J r� ���,,, , y/O ^///JJJ Fk0ER3U'nGHCpUNry�i• .yncn.-�—���'�o� ., � ' . _ _ _ " _ _ _ _ " _ ' _ _ _ " _ , r Y .___"" '__" _ " _ _ . . � a � 00 � DUiLICpTENUAIOER � -- I.iGKE� LlP HECBs A?d65E TO � Real Estate Tax SWtement GIBSONCOUNttTqEASUFER V4aCELN MBEq � A�P�aSvetl7byStafeBOardofAttcuntSforGibsonCouni pp� B ScC0:2DW5TALLh;ENT � 7o7N.�dainSL �. 004-00421-0 0 I I� �I�IIlII1IlilIIII�III�II�II�III�IIIIIIIII�IIII�IIIIIIIII�lllllllllll I 'T<revrnc" I Princeton.IN.1i670 T<IR4TE �-' iAXUJG UNR NAAtE I —'----�-..�'2C I • � � MOH.ESiE<D CqE�R � 1:. 8:559_ JOHNSON � W002610P1120220985CP• GROSSVq�UE E%EL:Pi/DED TAX4BLE I MONESTEADqNO � --����'��'-" } I VAlOE Gp05$TAX ORiEPT4%,iEES �EUNOIIENTI �ELI.VOOENT I BIISI.tiES�GipL � :S�Si63� �C NEPLACEMENTCpEDiTI NETTAX �� A 113100 35000I 78300 dPENnLnES ip% PENALiY PA�`� I TGi4L � J r; I o � o � I esi.i�' �o.3s szz.es � I ,,,. I i� � 6a:ea[ea 3 Robert Othmar / Nancy V Hasenour , � s., BR R2Box50 f,,,��` Haubstadt IN 47639 �` �� C ��"S° / I scnoo� s �.:�1l1 (� .-� ] ilrB/J � �% ll _ LUiJC�peav yjry DESCRIPitON o.se 150.90 33.99 SY4l..EEL >PPC 13.]9 331.50 19.1] 1.91 SPECIALASSESSMENTS ��� �Ax OELINOVENT STALL TA%orPENALTY PAIO. TOTAL 0.00 I PTNENEI]�lO.HiIpL610 ei�:/: 'Jl�i\A PNUNBER I _ OEEDEDOYMEq ��� I CHECK ❑ pq5q 1 F�0 ❑ � Haunouc floben ONrtuHNanc y ACFES � ! DDRE55 CHANGE ireasurerolGibsonCo701NMainPnnretonlN476700;(iceHOUrs8:00-4:Op a . TOTALDUE 522.85 ADD 10°; pENALTY AFfER DUE DATE - SEE TA% BILL INSTRUCTIONS 8 IMPORTANT CREDI.T INFORMATION'ON2REVERSE SIDE