Death Certificate - Simmons, Jearld R_1/25/2005ld
111 S. 8th St.
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CERTIFICATE OF DE
6/5/1938'
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Princeton, Indiana
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Iowell-Tims FY�neral Home '
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d States Air Forre
Heaclrick, Oklahoma
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JAN 2 5 2005
STATE OF OKLAHOr11A )
COUNTY OF JACKSON ) �� �� �
GIBSON COUNTY AUDITOR
I, SONYA TUTTEN, Court Clerk, within mrd for the Stafe and Cormty aforesaid, do
l�ereby certify that the above aiid joregoing is a jull, true, correct, and comp[ete copy oja
Certificate. .oj Deat/: received by 'r��e to be mailed to t/ie State Deparlmeitt oj Health, for
per»:anent filiiig in Oklahoma City, Oklahoma.
{YITNESS nry hand as Clerk and Officia! Sea1 this day of Alav , 1004.
SONYA TUTTEN, Court Clerk By Deputy