Death Certificate - Spindler, John F_11/25/2013 r-: - -Z.:. 1: aiM y,M E> - x;14 :aD.a . :1 1089810
P't INDIANA STATE DEPARTMENT OF HEALTH
1i CERTIFICATE OF DEATH
a Local No 001697 EDR No 000000340143 State No 040047
1.Decedents Legal Ha-no(Fret,Middle,Lis:) to Maroon Nan,Of farce) I 2.Sex 3.Time Of Death 4 Dale OI Dean O+on::2e 1t ear)
JOHN F SPINDLER I MALE 11:47 AM 08/24/2013
91 Molls Days rotes Moon, 02/17/1922 HAUBSTADT, IN
e. Ever in U.S.Armed Feriae? 10.11 Deaf Omervd In A Hasp a. lea Is Deses atunm Saneetore Ouw Than A HaspaS
E ItspW Faarty 0 Dececanta Hare 0 Nunig NmeALmplern Care Fatly
Yes 0 No 0 Urdlnoan 0 Inpa5em 0 Emergency Depr en Omaset 0 Dead on Anal O Otier(specify)
1:.Feynt Name(V Lin Ina:5t or.Give Snot and Nrnter)
DEACONESS HOSPICE CARE CENTER
12.Oar Or Tam,Slab,Aro Zip Code 13.Cot Of Dears hi,MCIOV Sao,Al Tins Of Deem
0 Mare 0 Mama,But Segura= 0 Dean'
EVANSVILLE, IN,47747 VANDERBURGH . E W'•De2C 0 Never Marie:: 0 Dehoan
15. Surviving Spree's Nate Zia Of Wle)Give Melsn Last Name 16. Deoeaams Uer!Oc.:.rpecon 17. Yd Of B.sr.sashgis-,
EMGE MEAT PACKING MEAT PACKING
18. Resberce-Sate 1Ea Corry I8c Gr Ce Town
INDIANA GIBSON HAUBSTADT
113.c Sae,:And Number tea AA Na tEa Zp Code 181. (nod.DryLans]_
Yes 0 No
405 SOUTH WEST STREET 47639 0
ie. D4amtts Eloise 20 C paean Of Lsspar.Cn2-. 21. CecawYs Race
HIGH SCHOOL GRADUATE OR GED
COMPLETED NOT HISPANIC While
Za FMCS Metre(Fest W Me,Last; 2'-,Mare's Name(Fest L'an_,Lard 23x.Horses Made,Last Name
ADAM SPINDLER THERESA SPINDLER V:ANNEMILLER
24.Inttnaes Name 24a.Relaorsrr To Deaden 245.Mail AEress(Sena Arc Nary,Ct,,State.Za Cede;
DIANA BEATTY DAUGHTER 108 SOUTH CAMPBELL BOULEVARD,HAUBSTADT, IN 47639
25.Place a Distiesro
2,a.Memo Of Cssposais'. 25t P1a e Of D ,osace [Name Ot C one,,Ore/rosin,sae-Plaza) 25c Location-Ch.Town.Are Se
0 Banal 0 Cremation 0 Dar.to 9 Er=a bensa
0 Rarno:a From State
0 Omer(Speoyr STS PETER AND PAUL CEMETERY HAUBSTADT,IN
26.Was Carona COct 27. Name An:Cotekte AM' s a FaaY Farik) 27z Far_.-a Hare Ucense Ninten
0 Yes 0 Na STODGHILL FUNERAL HOME INC. 500 E PARK ST HWY 168,FORT BRANCH, IN 47648 FH10900013
271. Srgrotse Or Inlay Farva'Sarni-e Licensee: I tic License Nana(a Lcavee):
ROBERT S STODGHILL, BY ELECTRONIC SIGNATURE FDD1024378
Cause Of Death (Sae Lmtructioa And Examples) Ideate
2E.Pat I.&ea Ile Owen a Everts -Deed=,YBLmes,Or Coma Iio'e-That Diets!;Caused The Oath Do Not Ergo-lamina,Events bony[ Onset
Surn As Cardiac ArreC Resit-eta-2 A'rast,Or Ventricular Fb ilea oon Wktnd Sra.'ry The Etiology.Do NY A:beviale Craw OMy One Cease Cr To Dah
A Lira. And Ad61na'Lines N Necessay.
Fan alp Case(Fret Disease Or Cava Res lts%h Death) A. RESPIRATORY FAILURE ONE DAY
a..ra ur.cennee a,
Sequent-37T List Gcndcxns, E Any,LeacHe To The Cause Listed On E. PROBABLE LUNG CANCER V.1TH LIVER AND BONE METASTASES MONTHS
Lne A Eater The Urdelyrc Case(Disease O.Ygvy T1 vtiatea
Dow.,s+•ra.rv<..a,
Tr*Events RcrJtn7 In Death)Las. C
a<<n..,rave o,
D.
Peel II.Ere Omier Set t Co,E]ms Carina-.to Gsn Bill N2 Reniteg In The U:ceyig Cane G•1n In Pa,l 22.Was An Auopsy Pstr,ned] o-- ®N,
PULMONARY FIBROSIS.RENAL FAILURE DEBILITY,FRAILTY 1A/se Alioxt'Fn4g AVmaTO lc Cana'ete Toe Cane CO Death? -
❑Yes No
31.Do TOOeso Us.Ca bsse To Dea's? 32. Y Femme. 31. Mama Or D at.
0 re...inn w..Pr 0 M14.0..11...ac.., 0..P.P.. 1 1/2•••■r.,c C a.or o.O, 0 Nara 0 Haio O IIt O Pending L..wiproo'
❑von ❑Ptrawl.❑No E uram.n
uM,.M1 hi FN+n CO..tat,..•FYrt 0,e, 0I..rvn•°"-..`teen no-Re v..: ❑Sleds!0 Cor Not Be Debminec
34.Oat Or Lnp%MoneRuaytsar) 3:. tare O lryesy 36. Place Of BM,(E.G.,Decedent s Home,Caru:u''ion Site,Rosen-art.%Shred Area) 37. Irtcry Al Was?
❑Yon 0 No
35. Laaeon Of berry-Sat 38a City On Tenor 38t Sreel d Iterar 3ec.Apt No. 3S' Zr Corr
39.Dea:ttte Hw Ir ry C2e:ed 40. If Teavperalon 1;.,,Sc®`)'
Dbea _ �Y.a�a--D.-c•-n
4:. Square.Of Pasco Certhirg Case Of Dar:: 42. Cem.Yr(Cneb Only Orel
DOUGLAS JAYE HATLER, BY ELECTRONIC SIGNATURE I C.rt rg Pmysiean ❑cao^e' 0 Hee.OLReer
43.Name,harass Ana Zip Cooe a Peer.Ceriyr Cane a DesO: 44. License Nate 45. Da:eased
DOUGLAS JAYE HAILER , 4495 FIRST AVENUE, EVANSVILLE, IN 47710 010399'37A 09/03/2013
46.ActiStata Rimini Sauce Procter. I 47. 'Alas:
48. Signature of Loo Hee!n ORS- 42. For Register Only -Date Flea (MonesDayiYee]:
RAYMOND W. NICHOLSON,JR., VIA ELECTRONIC SIGNATURE SEP 03 2013
AMENDV ENT TO CERTIFICATE Of DEATH(ENTRY OR ORIGINAL(
.::.Ss;e Fart 53395 ATTENTION ESTATE:Tie Social Sec y a a oeirg reo..atad by this stale agency in ode-to pursue respansraity. DLscaue is vofflry end Pere wE be no pint;for refusal
N?.4-20
: (W015) ...._ca-'-... -_ =r°':r "-d-° . . _.. ._...c_. . :