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Death Certificate - Montgomery, Darrell W_4/6/1983•. ..�NO. '�• ' STATE OF ILUNOIS �4]tV a srer[ ii�a - � ' RLGISTRqT10N ' nUm6[e • OISTitICT NO. � � . C� ' NUM3EFRED J� MEDICAL CERTIFICATE OF DEATH �" -y�- , . DL'Ct'AS[D-NAM , �is.r � .nmu�¢ , � wv 5�% DATLOFDLATH ��• �, Darrell W, Montgomery 2. Male 3, December 15� 1979 u' N� �„ 1'w1�{ uU;� wMlnlCwN ORILIN OH �Q6CCNT �G'- l UNDCR I YCwM VNDCN 1 O.�V O.�TC OI OIPTN I�^O..OnY. V[w�1 COUNTV pF OC�-`� ' In . C.I IiraCi � n ni Ivwal ao. WYiite 46.American 5,.?5 eb�� �� s�.V�� � s.Ju2p. 3, 19�� �,. 1�Page . C�����OVN.TWi.OAAO�00��Tn1<fwYUOLw ' MOiP1TI�LOROTMCHINSTITllT10N-n��[I�NUnuu [���1�•61vt�(11�[T ��r�OYOninii �n�ie�♦ � 1 O�/[r.[n. w.n..n:..�..r �� �c�i�� 1 �' � o'° �� �p 3 m �b. Winfield ��. Central DuPage Hospital �a. Inpatient 1.' � T � O Tp p u:T^[ EOIOIRTMpreo�m CITI2CnOIWM1�TCOUNTflY u�ARRI[O,NCVCHMIRNICD. NI�MEOI54RVNINGS�OUS[��uo[nx�y{,��wvq ��' G.(O, � N rm . ..n. COUwT11t1 . •. WIDOWCp.O1VORCEDIar[CIIVI � " g .Yy "`° o a< " e. Indlana 9. U. S. A. �o, Married ,,, f4ildred Sharp i � p a� � �� � LOCIA� , u�.,row.,rw..ow.o.om:r.m�„o. iHSmECrtr counrr srerc r y °, o m T� m' �^ , 1sa. 10� S. First St, ' „b. Ower.sville �4�, Yes �4d, Gibsor ��e, ZY!Qlc...a S c M T Z O FATNER - NAN9 r .�m�a �w�� MOTHLR -MA/DfNNAME rusr .ioo�� ..a.. . � N u o �Mae ° B °'� 9ugustLS W, Montgomer-6. Bertha Martin � o v.o � � •a . t5. � , O � INIJFMANY'8 6�uNATURC a RQL�TIOKlMV MAILIMG AD�RL55 PiwK�r.wpno.owe.�.o..Urvun�owx,Rw�l��p [ y O S 'n i� � ' . W/ J � a o" fO' = 0 17a. L G�n •� »b. Wife ,��.105 S. First St,, Owensville; Indiana � _� m�- `n ,��^ �� _"m' . � te. ' ocarH wns cLuseo o �.,.,�. o,..ONE uuao r �,�� .o. le�. �t�,. e �c11 � ���.> > TG � PART1. . . . imacoi acwu.c ` � �w."��o e i� o � o ' T � o . �... � . � �. � ../� � ..ro (ol ' r �� 0 Y. � j A CONOITIONS.IPqNV. OVC O, A6ACONE[OUENCCOI � p� � O. ' WXICM Glv! NIfE TO O T A -- T T O �"' IMMGOIATp C�USE 01 � ' ' '� n '� a - ' . � d ' STATINO TNti UNpF.N• , (h� � � � � , � • O S£ p. � d A � lVIN6CAU5lLAST. "DU6TO,OR/.61�COn8¢O NCQO• � �� _ �. O p � ' r _ � � .. °n o, � T 1 3 n ' lel � . �' T� � PARTII. or ERSIGNIF conoiLions: ��A.,.�o,...���.��o.00s.,.�o�.�o..a...o.oc.�,co�.m��...n�.i +u+orsr � ���.•••�••^_�^^•^ . ° o a ^ � �n � o n . %i .�// . %%�� . , rvu,.oi �:6:... ....�.�,,...,,.. . .�n ��q? rr- -Tn � a o � ' ' -(t�l ^ �vN� .G�n i9a. N� 1�Jb.., m S'^ Zn m2n T „ oercd�O�CRAT10N,1/ANY MAION/IwOINGBOIO�CF�T10N � "on vB� � n n r S ... 20a. � 206. ' N '.O ] � + O n ��TT[NO60TMC. IuOn�n.o�v.vunl I�nwin.o�r.runl u� I+ontw.Onr.�unl nO�IHOlOCwTn p a� O y • O d .. UCCGSC� /ROM: �/ Tp / w�w u �� p 0 0'. n v m B 21A. � �. � 7/ 270.� L�F ��7� 21c." 1'LC��� � % 21tl. 2:20 P� �� �, A ^ T " ro�.��.vor..v..now a. occ�.� � a.o.. n.o ..o or.�c.e��in�r...a �. c�' w 3'- � � . , oeresic�m �Me���.o.... ��� N� m � �' 22a.mcn�run� . a u..r L w�� / I , CG� , J S� � 7 m Z n =. a Hwrnceno ocrt¢ orc[nvici� 226. v� � pp A � I*r..o.rn�wq uurao�•.uCCns[nuMO[a j� � r O r. /• . T� . I1r. Paul E. Parker 4 4 Penns lvania Glen E11 n Illinois 6- J�U 5 f � 3 5' T m ''s.�'- 2YC. 1 ir Y 1 Y• I 22d. O.�. R� C� �d MAMGOII�TT[NOIf10INYpIC1ANI10TX6NTM.�NCCpTII1[q �t�rionr�in�l NOTE:IFANINJUHYWASINVOLVEDINTHISDEATN O NO,� � y .^ 23 � . ., TMECOPONERM06TOENOTFlEO. ^� �O 6 p � nI�' .ry �� YVXIIL.CRCMATIOX� CCMLTCMYOflCPCM1ITOHY-NAME LOCATION Ci�VO,ltOnn •TA�[ DATC IMOw�w.Owv.�[wwl "� Q. _ � � '� RCMOV/�LI���CIiYI . . �;; o� '�� ' 2a,. Burial zac. Maunee Cemeter . 2a�. Owensville Indiana 2aa.Dec.18, 1979 o B'P. � � � .uncnw�HOwe nwMa .......„o.�.....o.,...o. <�..o..o... ..... .�. 2_ S. a �, � zsa. Leonar.d e a ial H Ltd., 0 S. 033 Church St„ Winfield, Illinois 60190 r �- � . IUNCP11LpINCG JRJ61 •T pC ' eu��ouwiow�uueouuc[n�ane��u , . 256. ��.GCiw G�Lt�.-1Q- . � Y5<. 80=V8 .. lOC/�L Hl . �11�11'OD14 �l r OI�TC flCL'O OY LOCAL NCGISTP�PIMOnfw O�V � ww� • �[ / /1/�+ . , • 26a. � � ��.. l\ .�1/',C4':-Na. � ,,,�:v_ � ��.� ���r i cr Y�P-�.�.���. 266. �..:-G I.' � . / . VN[OOIRE .1/701 IIIlnoisOop9rt ontolPublioMOUlth-OIIIcoolVitnlRowrd� ie�aaooe�n��.�.����o��ocaero���ii�