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Death Certificate - Taylor, Caroline Sue_4/8/2014 pIiItxt.T!ftl1iilm.l gntlAWIi.tirlrl PDlipa:Ilill11ittclIdli1S 71rlILUiltlamin DIl.lf/1.1111.tRiy 111111afllrta ila l!1 ■
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•ATTENTION ESTATE:The Social Security R a - -"- -- " " --' `
be'up requesae aey this sale agency(n uer m
f 'pursue y canonry will n pons Oio root �6 INDIANA STATE DEPARTMENT OF HEALTH
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'Local No. Q6/J. 7.:4:.7.......... CERTIFICATE OF DEATH State No.
_+ THE RECORDS IN THIS SERIES ARE CONFIOENTIRL PER IC 1607-1-10
'PRINT ' DECEASED-""'C (Fat wan La/ Su I. Tilt OF DEA:- �m CATE OF DEA'.ua.,s.T.•
I a m p-1 N Caroline Sue Taylor I Female 11:2.AIM lune 21.2007
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(` ri b f•CRnY NAME Cl net Am on ens StFY AWI SN 9c OTY.TOWN OR tOC•TiOS Of DEAM Sa COtt-i- CO DEAD..
C I 1'i n 141 1804 Midland Ave. Princeton Gibson
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IN Gibson I Princeton 1804 Midland Ave.
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0mm .6 .L FAO4RS NAME Von 4roy Ld If MCT4.€RS NAME(ax•Aot•u.RY,Sr-.'..
m ?o o Ned Washer Hontas Copeland
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p z NAME aa•mEssaREASS wNO COMR.ETEDUt2Sc OF DEATH nrEM 26 IIIet/A.a
Ts:C Anthony W Stephens MD 3Rfl I Rellemendr.AL•P., vanc 'ille, IN 47714-
xi2 1 21 HEALTH OFFICERS SOLATLAE IT CATE FR.ED(Aes.Dry Yew)
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SOH06-004 State Form 10110(R5/1-95)
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