Death Certificate - Holderbaugh, Robert F_5/3/2012F
INDIANA STATE DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
No 000191 EDR No 000000256753
MALE I 12:51 PM
764586
04/21/2012
Hospilal
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NINA HOLDERBAUGH
826 SOUTH GIBSON STREET
�s. o«��r:eamx"
HIGH SCHOOL GRADUATE OR GED
NINA HOLDERBAUGH
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MOUNT OLYMPUS. IN
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�1. Sipnaire, OIPCSOnCeRtyYV�GuseOfDeaJ�: a2. Cert:ier (GeIXONiOne)
�HRISTOPHER BRADEN BY ELECTRONIC SIGNATURE � CeivfyingP�ysidan ❑ c��, ❑�anoaa�
�i lWne. FOatess PM La CaEe IX Persm CC„jvg Ca;ne Oi DeYI�: W. Lt¢n5e NuiMef <5. Da'e CuC:eE
�HRISTOPHER BR4DEN . 4055 GATEWAY BLVD. NEWBURGH. IN 47630 02003326A 04l24/2012
RICKY B YEAGER, VIA ELECTRC
Siz:s FOrm 53395 q77�MION ESTATE: The !
� NR4-20
. nir�s�
in ortler to pursue respassiDyry. Oistlosure ia
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