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Death Certificate - Williams, Ellsworth_8/8/2007I� I .;. ..s..,;.,.:� ..�..,;: ;==STAT .,-;:,::,:... •• � •;:�. ,s�, E OF A I �;,.:..•. .,;: ;,,:� RIZO A%:' �-`'a`� Certified Copy of Vit ecord `=`u � :,.,,�:: ! ORIGINAL STATE OF ARIZONA I , ;�.�J, STATECOPY . DEPARTMENTOFMEALTNSERVICES-VITALRECORDSSECT10Y OEAiHNO.. CERTIFICATE OF DEATH D 102- NAME Of • iY61 B u90.E C USi SE% DATE OF M�rviq pA� rEU� �EGEISEO OEAIM -�.. ELLS(UOR7H H• WILLTAh1S : dIALE �. FD DECEM1�BER 25 1984 HACE�e.9.'M4LOtack.Nnc¢ai4qan,et[J YfASOECEDENiOF5P.W611 IFYES,WDICqiEME%�CAN,SPqMSM, W/SDECEASEDEVEflWUS.Afl1AED ;�I�E UiHITE owcw.NU.�,o��eco-,�. cu�TOwc,w.��aM,.e,c. FoN�5i15PEpFYYESORN01. �� B 5. RACEOG ♦�rvn BiOVmoqul♦ C.Np$pIAIOO rymyya�n;�.rmsuuuuarrtvl D. �pp,� OE�iM W$iliUilON F��� 6 yUMA YUA1A 1930 ALLEN STREET a°°`"`" � F.``: ❑ N P�i1EM D�iEOF uppin pnv �EM �GE��EU6 511:�pEp�vEU� �fUrAEN�Wr MARWEO,NEVERMANqIED. $URVNWG pfx4E,CjyEy,�p[HHyq� � �" &ATM ��iQ^i�o��� Mp5 DRYS MNS. MW. NtDOWED.DNORCED�5PEC6Y� SPOUSE z. MARCH 7 190& e. lb e c -� s. MARRIED ,o. COD UIILNITE Si�iEOFplrotnUSA.mm�sm�nuy� CIiIZENOFWNAi SaEC�r $p� IOWHOqqiY p��� ���RESIDENCE �s INDIANA GIBSON OAKIAND 47660 STREETADDRE$$pq ; WSIDECITYLLWi59 ONPESERV�iION HOWLONGWNiIZON�i vREVqp55iRIE RFD. ISPECiFVV.eat.�o� �Spearyyeeprc� r[eq5 uoHrHS mrs OFflE51�ENCF ��.:i �SE. 115 FRANKLIN �sF. YES �x NU ,s 5 ,, FATHER'S wIYlS� BuOp�E C.u51 MOiMER'S ��y�5� BuWO�E 4twsi ' ' NAME MNOEN �' ,a. UIESLEY (UILLIAh1S "g"'E RHUDA GILLUb1 WFO 'S ruPE • nEUiwvavio �Ess Si41EETN0 GiY �NO SiAiE IDLOOE � /. � OECE/SED �;,••� Z�'' `�'�"`� • ( �, ,.. z�.SON �'� z2.� 1g30 ALLEN STREET yUbfA AZ. 85364 '.,�BURULCREM�TION, aiE CEMEiERYORCBEAUiORY—NnME/LOCATqN ENBALM ' IGNATU E / CEflT.NO. REMOVALOiMEP�Spet'dy� j9 �� REh10VA1 z..12/27/B4z5UlALNUT HILL CEMETERy,PETERSBURG,�6 �( e.�i�p_,_ z�' 6 � � �Nr�EPUnOUF w.uE SIREEI�➢p�ESS GIV�tIDS���E FUNEMLD OHay�'SOnac �as 1 GNATUflE) GERi.� zB KAM�.41NN ;.fORTUARY 795 Ul. 28TH S7R�ET YUMA AZ. 85364 �s � ac,L��.— ,�� � � �:� i0 iNE BEST Oi MY NHOWLEDGE, OEAiX OCGURNED AT THE TIYE. DATE ANO „W _ ON TNE 8�5�5 OF E%�MINATION �NOION INVESTI ATION, IM YT OPWION i vQ Z FIACE �MO DUE TO TXE CAUSE(5� STATED. I DEATM OCCURNED �T THE T�ME. OAiE �ND VIAG OUE TO TME CAUSE(5� �iz ]t �ND�iITIEE :% i�= M SIGn�TUREED.//�\) �' °LLa ¢s ]S.�IAIITLE /1 �/ ���� � . � uWN OAIESIG::EDIAb.Dav.vearl MOUPOFDEAiM .� pmat0 OPTESIGNcEUTpA1Lo..OjY.Vea1 , c MWROFDEATH ; ~'1 �[�> ]i J3 �� �ii 36 CL �UI.R 2 90 3I. � . �' � F o NMIEOF�TTENDWG�HYSILLWIfOTMERTMANCEFiIPIE ppp�ynl) ew W PROI.'O{{�ICj��Q �1Mp Q�y�Year PRONOUNCEDOEA01 1 ' � J� ~i /� JB.ON�/C�.[11�OCK L7, '1984 �9RT� � �i(' �1� � � N4AEAND�DDRESSOFCERiIflE(i.PHY51Cl ;N.E E%AAfviEflO iWB�IUw FORCEME �UMOR1iY�i onaMl ��;, .o RUBERT MALLUN ,tf , :E". �, 400 ZV � `� I -.� .�i N=i R" REGiitFNO GIS�R 5" • — , FEG i '�1 WiE Si'i[�FFCE,: T < :z. 631 .: .s :� ° -:. . 6. 6.IMNE TECAUSE �EXIENMYp1¢ WSEq1E+ M• FI 1 ` :��o I t J k¢� y fa J� 1.— . f A il, .,� �� �j�+_ �vvaow. [. � � 1 � _� F B.WETO.OFASAGONSEOUENCEOF: ���µ (IF �u:�� i �{ � _�C � 1 . BEN�EEN I. i a'a�� 4 'l i I ^ /� i G � C I'et'/L d !'t /lT fFF�� ONSEi ' �.s�d ��WETO.ON.�S�CONSEOUENGEOF� �� � II �;��: ��.,r� f{' � �.`�[`I GAMTG.OTMERSIGNIFqqNTGON0ITION$AND/ORENNRONMENiALFaCTO0.5ylaeuvlem.w�..van�vepeuntwuNnpast90Cays! �UTOPSY WASC REFERREOTOME0IGALE%AMWEA I� �I. (30eolYYes �� 150ec yYee ro) eB. \ <9. � �:I1 MutlNEBOFOE��n DnTEPF uo o.r .a ,pyp puURV�TwOWC1 DESCWBEHOVluaNBYOCGUaRED I" • : �SUn�I ❑��� IKIORY (30lCYYYesIXro) 1 � , c�us[5 rtMdxo 51 Si. M SJ 5�, i • ❑ wvESMU. � ' ❑��� ipn PUCE OF LVJURV �M Mmo. �am, so-eet, lacbry, oilce WMERE LOCAiEO? SiBEET AOORESS GfiY OR�TOIVN STATE ' I�� I� Q wibo[ ❑ �"�r[n- a^�+9. nc 1 SPEGFv r.[o 55. 56 � �� $UPPIEMENi�RYENTHIES • `.:� 5). � ! I " � . STATEOFARIZONA lss DATEISSUED ��%�� 0� jSQS � COUNTY OF MARICOPA ( j ' DEp This is a Irue and eua reproduaion of ihe document o(ficially registered and placed on file in �he VITAI RECORGS SECTIOV, `� �� `�Ot�P ,qly DEPARTMENT OF HEALTH SERVICES. PHOENI%, ARIZONA iswed under the au�hori�y of A.R.S. 343a7, and by direction of: �. h Z f. � �O� j ` d h S '� LLOYD F. NOVICK. M.D., Direclor '`� OytdO ��LQiY��—� ; � O � ��pY Dp�rtrnml ol M��IN Servlc�� i/// AlFON50 fiRAVO' y ,; SW� Rpbinr Asvstant Slale Regelrar , F. • q(TH gEQ' This copY ^o� valiti unlm preWred on ulay paper disObYing su2 ual in mlor and imprnsed wiih uiud seal ol ixuing agmry. i f : s `�, S