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Death Certificate - Rieffel, Janice A_6/18/1993l:J T nEGISTFATION "E o�Sia�CT uo. Ih FEGISTEnED � NUMBER +. Jani couNTroFOeAn�_ . 4. ' Wabash CERT�D COPY OF A DEATH RECORi� Si�TE Of RL�.upS Si�:E F2E � NUMfiE4 M ICAL EXAMINER'S — CORONER'S C :RTIFICATE OF DEATH �. ea. Mt. Carmei, IL ec. RR;4 BIRiHP�qCElfYrvwroSi�iEOn MAqRIED.NEVERMARRIED. NAMEOFSI Fa��+�Hn+�'I wIDOwED.ONORCED�SPept� �. Princeton, IN ea. Divorced ao. CRV, 7pWN, pq qpi ,�. RR34 ,3�. Mt. Ca STATE ZIPCODE RACErymrtE,euGKU.�EPCU. � � � I f1015 wow+..c.usvecar� ,3e. ,�. 62863 iaa. White FATHER-NAME FIqST MIDOIE I.A$T �s. Lester White wFORMANTSNAME(ivvEOAVnwp FELATIONSMIP ,�a. Relma Johnson (,A9other 18.PARTLt vrm�.vm,am meevmmeeo�noerowvncm�aq.g.ameo � Immeaantaeel�� r G6B1Y Cf Cl�f�1b1 !!5{0� PIOGM' � (a� � �/M 1r4 � �61�M+� • DUEiO.ORASACON5E0 ENCEOF 'CON�fT10NS. IF ANY �1 ') I WHICMGNER�SE70 � (b) e(- �Q.:�G.._ .-yr„�c � LYMEDIATECAUSE(a) DUETO.ORPS NSEOUENCEOF � STATING iHE UNDERLYING GUSE LAST. � (cl PARTII.ax. �onmumvmww,>,qmammnanewmqnwwwry.qow.y.�.,,,,a..mi. �� NATUqALACCIOEM.YOMICIOE. �OATEOFI,WURYpnOnMWr.vEw� Hi iunr OAiEOF91FiH�i.roHiH. � se. Se tembe W E1iHER.GNE SiREEaND rvUMOER� ISE Ir.woENwuE.iFwR£I Rel�na u.la�cunl P.YR 1 zoa. Natural Zpp, p�, M py LWURYATLVOFiK PLACEOFNLIURYI�iHOUE.FUw.SiREEi, LOCAiION�CrtY,vLpq:ryrcH;pqiyip,;pq 1�'ESrv01 f�CiOPV.OFSiCEBU4DwG.EtC.115PECiM 20e. 21M. ICERTiFYTHATINMVOPINI0NBA5EDUPONMYINVESi7GATONANDNR TNEDEGEDENiWA$PI THE WOUIS(i10N. THI$ OEATN OCCURRED ON THE �ATE, AT THE PIACE "o^� , 21a M'DDUETOiHEGAU5E151STATED.ANDTHAT ....................... 21C. MaYf�ii 2Ad ruuE SRiEEfuIDNUNBEROR RF.�. '+a.'v2lan.i�H9� � �moeoamena YE�Ri � IYESWI LV�I, IIV 4/b/U � ...�a..1.h.nrw EMEwpSEiuQCf�N os....o.cs...�ae.. IvESrv01 mwem�auus[v¢.rv.� t9a. Nn 79D. 7CCURRED �FmFA wnlqE OF LYq�py wExipNm w a rtEU �el q..CWNiV.Si�TE1 GFE1ulE.WhSilIERE�V rav+crwvtisrnr¢eu5 20h. YES L' NO CEDOEPDON AT nr .Ew 21 C. DATESiGNED �uo�nti.p,�r.v6wi _ za. March 12,1993 Irec. March ' wN SiATE O 2 CIIYOPTOYm 5{�}E L9 ��Z�� o er tocu q[c.�^.rn,.a �wNTM. o�r. rcw� �%� /� . s y �a�seo e« isw us. srum.no cermFUre� 1 H°RE9Y C�R71F1' THAT rhe fonooing is c true ana <arrec: cocy o% 'he dec*n recoro ior ine ae<eoenr nom.ed ar itee. :, anc tnm �hiz recnre ..os. esra'nlished rna filea fn my arriee in occorconce ..-itn r6e oro�izions or rhe lllinois zta::::es. DATE ��i�,ac.� �� i 6 S 3 _ SIG�%ED��L�� T Mt. Cfl2'nL Ulino�s. OFFICI:\LTITLE— Re¢�strQr' % ��(�J�� //`��, -� —, Th� ennn�l '�cvm af tni. de��t i. rerm�nmU• nIN r�t- � v�ei7CC�in� l 1f \. O, l� L'�F.ALT nv nrn.4il. l'a��.1 revu�rnr .r. �umanswl tn mu� rert�nrnuen. fmm evo�o o(/!ne rnvm. . eru. 7h� Illmm, uui.. nru.ule u�ui i� rrurce�)on .: n �v��n .+-urn r• �ne Ikwrt.Rm of Puelm RwN ur tl�e lue�l repiwv or m; � cbumv ner. .n�ll pe pnmu I.na .v�uenc� m w ewn. .nn ��maA ui vne ism �nw•m .uw�. / VS :�lA (1961 re.is7onl BUREAU O� o�Aii57:C: -:1UN015 ncopqTME47 GF ?U^LiC �?�L iH - ir'+IN:;=!�� D