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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 ■ :�: ,r . -.,-v- �-- r> = 136862 •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 6 ;" oknny ann. wtl Ce no�pRnnR.^:/ar r6i:rJ. '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 M y r 3 im i' * WAS VEiEPF.NT eb sL.e LAST ammx A. Putt a ocAnr MN..WAS US AAAED FORCES —'s Sx"•a'•') f- *Z m ROSbTU ❑4u+• oToe ❑w.ro tamp ❑Ore cy.<ry, C`- Dx i\0 :?LA ❑Ewore...r. ❑004 I S R...<.c• (` 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 pi ::.<7...- II mARTU STATUS it SLVNYMC.SPOUSE CECEOENrs USUA.SCI5ATWN(an,owca� In rtYJ OF BNWESSTOUSIR. DZ( (seeees, (S M.9o•fte o mewl pyy pF.y esYd..u•M Y•�IHY .e.6l r. . >p p Married William F.Taylor Secretary School Corp. L NESd%NCE-STATE :30'COUNTY tic CRY,iONN OA LOCATIO: Iy s:EEEi RHO N'wn1R (J OmT I IN Gibson I Princeton 1804 Midland Ave. ---2 Tmo •y ZIP COOS Ix NSDE CITY LAMS I(I. CITIZEN OF IS WASDErF<YNT O HSP•NIC OR'CNW 16 AACE- �Oz - X en N, 0.n• R rx•e.c..Ca•n SMn •,.Ott Mv_ 1 c. oft,NNT Sva TonON _ L:n'e r•.4r COUN:A.r � • Ott I f5ac•rMNV.•YVO<+vrC X Z t1•' ON•"'Ain Ynvr Aix fc.I ore1 • Ew.v,l/Sx/nf.r ID-1?) _� 47670 U.S.A. I ICO230.•^5.1 mp kn. eYx white 12 2 0mm .6 .L FAO4RS NAME Von 4roy Ld If MCT4.€RS NAME(ax•Aot•u.RY,Sr-.'.. m ?o o Ned Washer Hontas Copeland M ^> T TE• I60M4NTS NAUE(Tna/A^• XL .LLwin Lrs SS LGr.sr M.mr.v 4.0 A...wsr.C.-s F...Ma 7.Cos, no R.Y.s.e o > a m°(ANT William F. "13.11" Taylor I- "'>j 1804 Midland Ave., Princeton, IN 47670 Husband a 2 211 .E MOO Of OSROSITON ❑En Mew. 216 0..E Arc PLACE O<06rpSTION 0 ,,.of Tree"pq,+,'o- 212 LOCATIM-C.a re-.,um. co t> F. IS e,x. ❑a.-an ❑R•.o,Y I.O.sun, «rr.w<.I Jun 25, 7007 C Dew. ❑oc.L7Px.,, Columbia "White" Church Cemetery I1 rineelon IN -C ZN 9TION n• "RIAM"5 NAME 22s OSUMI,StrCENSE NO 22 WAS DEAD.RROPTED TO COAO.YR• M o John W Wells 11)01009940 tR No to 01 n 2•• 5151' CS ILYRey?SEC TOR 2.. •K3 SENIJWVR It NAM(•'ass ALO u:ENst..i. 11 of ro,Enai..ono J (dLCn..0 { Colvin Funeral Home. Inc. F1183005671 rn m C `/` ,L-:�J'� _-� 1001009940 425 North Main Street. Princeton, IN 47670- -r > 2e PART l a Frew re O••••••n..w 0,50 ca 0.P 710314.1711 6••Y.De M.nY nwp.cl.<isms.uca x Crete to.non's} AAer..nn. p z nit A.m.a MAT"6157 La err o-• 7x76,• Mv.10•<.wr p 2 t RS,FAATE CAUSE IFw .51 C`ice`-.A`C ca Vl`C/ / p Fs • e..mo-<nmm CUE TO LOA AS•CONSFO:ENCEM X m 2 OF .ab"....em O !JP, 6 T T p case a .Nn y• DUE IC TOP AS A CONSEQUENCE OF) p ID r..,a A.x77..•..4 < a !n.0'"FY.tr+O DU TO(OR AS A CdCE NCE OFI co i-p 2 z 6 -_ PART 6 Ora.art am,ecrw•-Ceram.CO x,.c tee S NT.v.•4Mr w.•.Pr'r O Co 71 WAS.aAI CECEXN: ]Fa WAS s'AUTOPSY 2!6 METE AUTOPSY I F10 Fwp<o5 Z p C PREGNANT OR SC OATS ('.0 EO2 •vµ.7[4O TO .-1 POSTRARNMr (vas and COTE DON OF CAUSE '( mT Ivxare: OF OFI i.•<yx OW N g 5 __ No No No m JOQ '9•taro LS CERi6V WO MVSp•x TA n•1YdmItrc.YC9V 02nD z[O•x Ym•Yr u.MW,.•p e..en.cu7YOx nxn. ~- wl 0•4.Ln.KRICER 1"471 ma d mane.Wle.r•ncxv..-.-.r wan c••.*cam Y thin c'.FS puce.v naves,flare n nod m • FIT:m G COAOr*R OnM•wadn..rm,7mler.fa*Snat NY,o<.cn ow wwareFR.Ir.en•ro dx7 v6 o-r•x et wv7.IY nee nwa•.*0706 y����1`\�'>m� 'm M6 SNS.4TURE 4MO TITLE X CERTFeF "1 r . i 29c MEDICAL LICENS1 NC 7% DATE SIGNED(NT ar ••'1 ` s Z ER LF.W-! .r t.c' I o IC Li-C.4 Cc., b CTZ RI p 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) l srrl < a J /.`r/"EGL �./'�. 1/! . .'v 144. Jam, 072 x Z m 22 MANNER Or OE•rn Y• OATS OF NAVRY S•6 TeSE OF Yr NAIRY•T wORAT Y6 DESCRBE.Ow NAM•()CCGREJ"" N> = C4/1 ra, .7.7J71 ""x4"70 EX 11811/0 ❑�.4nc • 57 a 4«..n a•tt 0 Sacco 0 Carew o. Y. ace,OF NJF._Ar nOy lv.rN -..tl'<. ( TA. LQ'JrIY:(Sb..rwN.•aMr R.YWR,NraY.clra 72nD 5:7.: O...s.n 07M.0•'(SAw"lyl ❑HTE P , ..o- r< .r ,.,o-.7.., Y9 DATE RRO7oLneED oEAC 4M:.•u.Ya: 6^ ...TOR vErueu.000ENr• ',el • ,new,a 4...w a . SOH06-004 State Form 10110(R5/1-95) zI. , if , HIV+-20 . . .- (7/05) :. y