Death Certificate - Dewig, Paul T_9/14/2017 1; fi`r , > 1 6 e 2 a . '
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Fj ii : 7 r . 1 ! < ..;: ; • 4ERTIFICk1 OE DEATH y 1 :'r s ` } ,I.. 4 3 -t `1
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`.Ne T �`• r1lo 4000.0-24 `. `'• �.EDRNo 0000005116307` .. state4 027625"\. .`L
Lbmmanaca a t i s 6a'4',a_LICae.LmW* :.s,.' 1s M,k nName T X sk..+ i, aEa a Rea 0100901 4.Ds±a Deer,, r:
i PAUL TIlOMAS-DEMG ".` - ? ` • 5 '� ."• iNIALE` '109.•00 PM " ,A,06/09a0115 r
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- 5s '>, cM + .0" '•. `: - 072071980 EVANSVILLE,IN , -. 'a; mD.sAm,eaFao:n; latf Dada OlaneIAHotplbt Sov.N,¢Ox,ailm,AHmpsd: . .
- 1pa uooa7,aauvma_
�,.:: Cxawke FVeRry ®',DemOmr.Hma C,mseap Haroaaptem,Ca.Fmb:. �
0 Yes ONO 011Nmo.a1 0 bgalmp 0 Ema9�YDopa000MOu si 0 DesomMnval .0 Oear(Speatll - '
It FedbNVab Ct N0-treatan GAO Streit sal Nbmem)
9449 WEST 450 ROAD SOUTH _ . - .
12.gaTOat Sta.Atd O'Cade 7 u Casa Of Dee, - 14.AC Shea AI Dm Of Oen
MadmO Merest.adSeamed ODSame•OWENSVILLE,IN 47685 GIBSON . 0 Mldeaae 0 Newer vale 0 Wircae•
15.Saawg Swafl Nam - 15e.tea Nam Detre Fns Nrc, 1d Dot UN=0=31 17.Pada am,e,.&a y.
ASSEMBLY 'AUTOMOTIVE
IL Rnaam-Bab , We Crib - : 18O Cal Or
INDIANA GIBSON OWENSVILLE
1St Seed AM Rooter . laa Apt Ha . 180-Zip Code Sat rims ay 12371
0 Yes O No
9449 WEST 450 ROAD SOUTH 47665 ,
19.Demean E xaaal . - 20.Decedent Of Hate Orl t 21. Deaeear.Ram .
HIGH SCHOOL GRADUATE OR GED
COMPLETED NOT HISPANIC • White
22.Pets tame(Flat LIMA Leal 23.Pants Nam(Fist MJdfIt Watt 230-Prar.Lad Nam Debre Fat Nrudaw
WILLIAM E.DEWIG HELEN M DEWIG TIEPE
24 t write Nam 24a RdaaaatlpTo Decede4 24n Moat Addms(Scam Aid N.*a.Ca.Stud;Cede)
KENNETH.1 DEWIG " BROTHER • 9449 WEST 185 HIGHWAY,OWENSVILLE, IN 47665
25.Face Of Dagestan
25a Melva ODnpaam 250.Flom Of Dlspas'We Cade aCaaotary.Crematory,OTer pea) 25c Leak,-Ca,Twa,,AM Sera
0 Ewa 0 Creredim O Donasm 0 Eromenten
0 Remora From Sale
0 xm(SFarre EVANSVILLE CREMATORY EVANSVILLE,IN
2a Wes Comte Caarted? 27.Nam AMCadieta Address Of Funeral Faddy 90- Fatal Kane Lana tab=
0 Yet 0 No WADE FUNERAL HOME INC, 119 S.VINE STREET,HAUBSTADT,IN 47639 FH63002990
n0-Srtre Of man Emma Savior Llmnaea I 23e License Karat(Of Uansee)
ALAN J.WADE,BY ELECTRONIC SIGNATURE . FD01017080
Cause Of Death (See hxeucdens And Examples) Appadmme
28,Pan L Enter Tam 02targevaa -Dlseeses,tr',3ciet.0r Completions-Thal Deady Caned The Dean Do Not EMT Terminal Everts Cravat Onset
Such As Cadaa Met Resaatay Aural Or Vandladta Fitalallon VF9,ad&R w'Ng The Eedopy.Do Not MSevbte Erna Orel One Cause On To Death
A Lime. Add Add7iond Liar If kto=ary.
lotted=Cause(Fad Dame Or CoMllan Reeted o In Dean) A SUDDEN CARDIAC EVENT OWED
woman's*440.444444 no
Seconnadp List t EMT,LoDeg To The Cause UNDO On B.
LM A Eider The Underlying Caw(Disease Or Baal Thal eralIea °r•P`.�-..BOO
The Evans Reatsp M Dead)Last c.
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D.
Pets Enter CanrESZIEVEILD9LCISIELOICEnStO5123 Bid Na Reside at The Lotaltrc Cana Man In P.d I 2.Its An Aet iy PaNnaen 0Yes 0 N
31 WELm MSpay Radne Aran]b To Coxpbs The Cane Of Dat.? a Yes a No
M.Did Tobacco Use COtate To O.eN2 32.If Fends 33.acme a Oast
0 Fa ®PnOad)0 Na 0 Unwm
a wrap.e.o„wv.. 0%rail m.aa.a Nat Para.es e.nw•ara ewao.m 0 T aaaal 0 Hmilde 0 Aalard 0 Peaa,e tm'esseaa,
w N.p..mem.p.. oomals.mem+ v C 9Ltlds 0 Ca.Net Be Dvtar,lmd
34.Deb Cl terry p(mOSOerWers) 35.Tan Of lry'ay ❑ ( rr Cmw,cda,Sao.Retract YAodod Arm) 37.fluty Vant7 •
66666 0 Yea 0 No
at Laaam Of trial-Snb Sea Car Or Tom 3913 Street a MMoablr 38c Apt.No. Md. 2ep Code
• . SEP 14 2017
30-Desaae How trVyOmaed HTraapaa, _ aalfa
40. Cfre. UPgriatin 0
aseM
41.5peture.a Pas'Gretna Cane 010=3 fin+ - .2 Carder Owlet Dd,Ca)
BARRETT W.DOYLE,BY ELECTRONIC SIGNATURE GIBSQN COT)NTV AUDITOR 10Ct rq Pfy"'ao knerater 0noe aaa
a Rya Address And 2w Cole O Penal CpmL:v Cane aDoan: 44.LlmaeNtaa 45.Date Carteret
BARRETT W.DOYLE ,520 SOUTH MAIN ST, PRINCETON,IN 47670 - 0611312016
as AOSbnd Nowa Sac®Palma: _ 4T.War
43.Scutuod Loral Haan aSOrr. 40- For RaelatetOny -vita Rod L4otVDaNY4743
BRUCE BRINK JR,VIA ELECTRONIC SIGNATURE JUN 14 2016
AMENDMENT TO CERTIFICATE OF DEATN(ENTRY OR ORIGINAL) .
`.I 0-b- 17 03= Loo -boa• as '7- �
5bb Form 53395 ATTENTION ESTATE:TM Soda Seauty a is tong requested oY to slate aoercy it ads to pets?iesponsaidy. D'.dm_as ly co/men?a'4 Uteri weal be no panty far relbaL
WAR SIN G...T(t .TOYELIDLLWHENRUBDEOOWOINM.000UNENT HAS HIDDEN.VO)DONFA THAT APPEARS INNENPHOTOCLPGIDUN AQNBACKTHAT '