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Death Certificate - Stoops, Joseph L_1/6/2016 t---,:l9ct "/•,:=:Tir'7';'.7--::1,%=Trr-ku(ftc.:',•:::"ir•Th I.° ,. ..:;4..:.4., 4. . '.9 7. •..1i. .: .•. 24.". I Il:, . '',...-t :-;:;;;;;;;;;;-1;1+,7,I;;;;;I.74;;;;;01-I€7;47. 'II 1;;;14.;I'''.:;;;- T, .t.4 ti-,. .. 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', -.. : . :' i; 82 i ;. 5,96m5 : -../. PaYs,. 'I, / :Hams 4,r: c cliajAaa ;2 ; 3 " 1'112711933I - - IN f--,IN 9.,Ever El U.S.Armed Forces-7, la If Derrth Oscared In A Hosaatal- ,.. •• ,.,' 'F' 1 " .10a. If Death Occurred Somewhere Orr ThanA HosMad ..- k - ,4 ) 4,,>. 3 I ■,, '%„d ...c .'". ..- C....., :SZZ,.... ..- C ....).el.:: ...,\,--6„-‘, ::.,.:::-., .:`,:-,','..' 0 Heats Farl:ry 0 ReceSent's Halle' .•0•Nonirol Hernaaang-term.Care.Faatty c• -.„..,...,; ........ 0YeS 0 NO'b Unknorrri 0 liGnayeth,0.E4ergencY 0;thalrere avtleleg 0 Dead&CAInvar'0 OtherlSpejfyi: ,2 --'44,,.. ':-..- 4<" -4*. sr .'`'‘. `k -. ''‘'''' ''... 11.Fay Warn/31U Not Instinen.Give Street and Numees). t s: ;. : : -... : -,,, ; , -it. c , ,. . %',.... = " ' ' . , ? - • - - 237 SOUTH GIBSON STREET ; :. :; ' ; 1 • : ; .; : ; : 12.City Or Town.State,Anna',Code ' -; '- ' ' - s s i sisiG/xnty OLDeath ' ; 144,Mantal Steals Tree Or Death. L. •2 s : i PRINCETON;IN747670 , --- • ' 4, - ,,,- . ; i•ff,' •I:;-:::•,•,. GIBSON. .-.:r.:-:•"?..://- ------ 1.32m4".«ed 1:1 Nc7Fsisplarrise,.,O un ..-• ,... . •- ,.. 15a Of art,Maiden Last Name .., ; , la,..Clecedent's Usual Occamatort % :17.,IOnd Of BusinessAndusay• •, I • • %.. 4,) , 4.. % ,, 4, ; ; 4. if ' 4. %3 ', •I , 1 ; UNITED STATES DEA ' •-.1 REBECCA STOOPS . . • . „ . ' ' HENDRIX % 7 % 3 . ,- if: NAVY- ::. : , , c AND PENTAGON';.. III Realm-ea..State,4 7 ' 18a. County - ... . .. . ..- INDIANA .''' '-. ; . •; - : GIBSON .. - .. :-'--r. ...: •c- / PRINCETON ,•;2::„ :: :„, .'.„ , • • • , , , . •...,... , . . . , SOUTH 237 sou GIBSON STREET i , •, :? : ; I , . .,z ; 3 L; ,: -, ...r. , 12 :-. : I, .:1 • : ; . : , 47670, . . . 0 21. Decedeirs HIGH SCHOOL GRADUAt E OR GED • • ‘.. „• ..„...,• ••,,,,,„,..., • . / -..„, ... ,i 4:„ .,,,- .. . • "- • •••• • ‘, 22.FaTiers Name(OM Ma,Last) , , ' 23a mothers Maicien Last Name•' . ELMER STOOPS , 1 '. , . : ;s. - ;I. ' BESSIE STOOPS ? .: : ' : . : . VANDEVERT : : • •, ' 2aa Rotation/lip ToOeceaers S, , 24o.Maing AddraS(So-eel And Number,City. .2zp Code) •, •; 4 ; % v , .: ., ..I REBECCA STOOPS - ' WIFE-• - :,•--:. ,• '2:I: 237;SOUTHGIBSON'STREET, PRINdETON,•IN 47670.•‘ : .-.-../: '''....,:..' '1 - 25e Method of Disposacn I ' ; • ' 25e.Race Of Discesison(Name Of Cemetery,Crematory.Other Race) , 25c.Locator'-Qty.Tomn,And State ., - , 0&nal 0,C.xernabal,adoclaio,n 0 EraianaXneil i • :, ' : --- -, .: . : . . '! , ;t e :. , 1 - • ) . • . ! • ' 0 Remo:cal From Stra -' ; : • ' . . . . , 0 oth‘r(sPorfr):. ...,-j ' . .„ ., - MAPLE HILL ... •?. ; ., ,. -. ..," PRINCETON,IN ' - . . .. • • ' ' i`4e; .. ' • ' , , ' . , , 4 . •., „ ;, • . „ , ; , , 26 Was CacneCoriaeted? -'-. 27 Natne AM Cornpw.e AOdressOtFulefal Fealty ,/' -- ; 't- "": -.- - - ' , - 21a Etmeral Hare Licerae Number • 0 Yes 21 No • ' . .. COLVIN FUNERAL HOME INC;.42 ,5 N'MAIN,ST., PRINCETON, IN .47670 ; •. : : FH83095671 i ', '" 27b. Signets,'01 insane Fall"'al Service Licensee: i ., : , • ' y ' " ; .., s z 2 , 2 S. s- L c - :: 27c. License Ntriber(01 Licansee):: i:, ' ' " . 1. C MARK R.WALTER/BY ELECTRONIC SIGNATURE I I? . -.... ,," i : ..-..' 3 -.. '-: - FD01013010. ;...; i.. : . , , ? ...„; : s . • - - .• -•.. .. ' • • . r.Cause Of Death (See IrtstruCtiC4,sAnd Examples),, 3. .. ; c,„ 125.Pert I.EnteiThe Q ii11 -Diseases,*nes.Or Complicatithis-_,That'Direct)y CliOe d The Dthh Do Not Enter,Ter-misal Ev'ents--- -1 .. Inter:tat Onset"..: Such As Cardiac Arrest:Respistory Alit;Or Verariadar Fascination Without Showing The Egology,Do Not Annetiate."Enter,Only One CausiOn. To Death . . ' A Line Add*deaths!L nas If Necessary : . . .. , i . . Immediate Cause(Final Disease Or Condition Resiging In Death) A_ si,v4LeCELE:CARCINOMA OF LUNG WITH METSTASES TO LIVER 3 MONTHS I' .• . , ' , ; _...? - I '4,. 904.".*.!."" ca rr a . . . : : :S „..... +. s f 4 '''/; % C t ,. \ Seggerthatly List CooSons. g Any.LeadingTo The Cause Listed On B EMPHYSEMA , - . ;. , , (sick EnterTheUndertgCaU5O(Di5ea5OOtItcZY'fl1at I -,,/ , tc , The Events ResiuttirgIn pe....ral • • . • .. . • . ; ; : r - • ; , • , - f i : . i. • . D. 1-6(PoiEit■ ...;." ; I ; i. i -: . I : . : : • ' : ; . . , .2 vtal4s' 'Part IL Enter OtheracolcontloacnatataraILRLM.sTrb GUI alot Resit:Nth Tlse UpplertyingCause Caro In Patti •• ..• 29 was AnAteccaY RerIarlsen' .• .a ye; .co'Nc, ' i:: %.; '4"'''' : . ... ,.. . .. CORONARY ARTERY DISEASE RENAL FAILURE ` • . ", : t t% f - '. s 1 ' • 0 vn Pnev4 meth Pm Yvv 0 4.4.ththini SH.a Dun nni vn445vtiim at q'tcnt IN.1 42 1:41,08 ryit.p t Neural 0 Fcise .0 iccident 0 Penaing Invesagation t- ' 0 Yes . . . 0 nRSe e(NT P 0 y Cu'n„. • Ef or:sar i r,17..aiwes,it.arts '7 d auade crokid. i. a rD' .. ., , S 34 Date Of INY MurDairear) 35 Tana CI intaY - .• RS.Plae 01 ba/(EG.Decedents Hone,Ccostarc Site,Resatrant weed flea)' - 37 Injry AIMrk? - - . . , .0 Y 0 NO • 4 ' ' 38 Iscaton Of Iretry I Sara t % .7. t t, 4. 4, : : ' '' ', • •' ' % ' '., t " , . . . r ' . . 39.Describe Hoe Irian,Oasmneo - ' , ' , ' . . , , 41. Solace;Of Person Ger:4ft Ccone Of Ceti: I. KRISHNA MURTHY, BY ELECTRONIC SIGNATURE; ''.. ', ;i ; • "', '• 1- ,- - I'. ; ,•-•-. LEI Certifiln9 RITMcIen • 0 COMM" . 0 43.Name,Aradress And Zip Code Of Penal Candying Cause Of Deals - - - , '.. •e t: +...--t ; ; .r. : 4 -.) t-, 44. been?!ramps, : , . 45, Da,pert69d. . ,. . j , -,, i• I ; : 4. , _ , • , . e . - •-: ''.. i ? KRISHNA MURTHY ,685 VAIL STREET, PRINCETON,IN 4767.0•=, ...: ,..- - -- .• -.. -. ., . • - - 01031888A .. : , ••• . 12/09/2015 , •. 46_Rignatore of Lscal HeaRIOfter.r ,' - - - - --.• ,' ,,.//,.., -`,. 4., i i" ',• -;;.....- , ... 4 9: Fa r Regtsraf Ouly Dab Tsed(sosv paTive ,... ..,c ..,,..,n BRUCE JR VIA ELECTRONIC SIGNATURE : 4 : 1-DEC(10 2015 . i ''',. 1,) :( 1 -c i t :‘ ,. ;.. s :. .f Ir., z. ; :: I. i AMENDMENT TO.CERTIFICATE OF DEATH(ENTRY OR ORIGINAL) 4 Ss T T., t:ti. 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MENT •A MUL COLORED.BACBGROUNITON. ,ECTAL WHITE SECURITYPATTER-AND:THE GREAT SEAL Of.THE STATE OEININANA ON BACK THAL, 4.a.C .•,TURNS.F-• ORANGETOYELWW WHEN RUBBEDWRIGINACDOCUMENT HAS HIDDEN ei 4 ON FRONT THAT.APPEARS WHEN PHOTO COPIEET>2.-4+“::,>.C-1:14...I4.4M2.4:::;""'I