Loading...
Death Certificate - Phillips, Bill G_4/11/2018 02,:13. vG F1`f r° t vi'�.`.�.',tC1 j".CERTIFICATE OF DEATH I7 -'P�,r�,-`�.;`C i. :G;-:,;aS 1 _.u�)2. �� ``,-It INDIANA STATE DEPARTMENT OF HEALTH fir•{ )�` t t ' CERTIFICATE'OF:DEATH 44<1's}, " J 000000623192 state No 003882 )114 - \ , , I., ... 1 Local No 000026 • EDR No ,.,4. 1.Deeaate Legal Ns,-(FistM M.Lm) fa Haan Name(tl rang) -' 2.Ses, 3.Tire a DKr. -1 �a,L 01 Dear pbmAry44at -J p. ✓IE[h -. SUS _ (U) 'tr" ' 1"L BILL G PHILLIPS -1:-.Are - MALE 01:20 PM 01200118. - r`. 91 aspasr t";.. Dare - _ .noes ,W'a's • HOya.- p ,_`Y•l'' - 'b.F'' 0lMOmse Fray 0 Deceaes Hoe. .0 Mac HmrlagrroCm Fealty '-5 •D Yes O No1�O Unknown 0 flame 0 Em asa Dtpan.LOSeal 0 On✓ahA to 0(7av(SPea,T - ('11%,Nt - tV I11.Fealty Nene(Nth Vshisca&es SSM et Nara) �� .. {,••ate l RIVEROAKS HEALTH CAMPUS :in, - tr&gr" _ [yJ� p( 12.Cy Or To*n Sista AN Zy Cade - ` \-�- • 13.Ca J' O(De�A�:k , 14.Metal Status At Tens a Darn . �4`�il �4• �. G� ®Manta0 Manisa Da SrpareeaC d'Oma®e7 • PRINCETON,IN,47670 .'Rte, - • LGIBSD .. - - 0 webo s - 0 Ne`Q1fnt°1 aDkt I L( 1St Strang SpamY Nara - 1 nee i a W t 1<I `{si• MARY PHILLIPS HUNPa!' - - RETIRED.FARMER SV')- FARMING » f t( 111 ,Rmmao-Ss, tx CaaaY j � 2U'v. ,1st OfyOr TOes+ a -_ Y5[1A ,+. f ,-] INDIANA < . GIBSON 4 - e PRINCETON. 1 � h. L c a Street Are Hater '*• 'Si" • lea Asa No. 1St Zg Cede 131.Omde Gay Las? )44 •A<.; 1244 VAIL ST + �t.: ^hN 47670 �t�1���y;"" y') lyi 19.Daudet:EGUOam 2D. Cesare a HerracUeP, titNN 21.Deceevri Rae - -e. .) N. to HIGH SCHOOL GRADUATE OR GED .ts.i T .. - R 'PI1 - a COMPLETED - NOT HISPANIC . . White /PI, a. yc 4 22 Palls Now(Fast Msme.Lag r 21.Pners Nape(FAG YYffi.lsFp t••i 23a Pasta Last Nana Before Fes Manwa )' • ,!, LUTHER PHILLIPS - -. ELECTA PHILLIPS '4' - MAXEY en 24.Samara Nam 5' _ Na Reboo!Nte To Deoaeare' 240.Karp Mtrm(Star AN taarter,City,Sues,Da Cab) - t`.,1U' C N LORI MASON r h;tG. ' DAUGHTER . 1• 78 N.SILVER CRESCENT COURT,THE WOODLANDS,TX 7738 Q. : , .r. 'Cr 25e.Athol Of Deco an '- 2Sb.Race Of Dispoaapi(Nave OL Cemery.career?..Oa-.Race) : 23c?grin-Cty,Tact AN SIate 1 `II* - t. - W ®Bows,p Damao 0 ores,0 Emnenaa - � V ,eL'Lk" '2i �. Q 0 Rrso.a Fan Sera 2`rCtl - 1 ✓-'y,�'+,4 At 'O p ona'(S yt MONTGOMERY'CEMETERY OAKLAND CR Y,-IN LIz` :. S O 26.Was Cash Coaster? 27.;Nece AN Carpets Address aFwaFardty - ( lam - tudtr 27a-RMalHoveLmmt 9 W cc . LAMB BASHAM MEMORIAL CHAPEL,INC 226 E.-WASHINGTON STREET,OAKLAND CITY, /r, m ❑rev 0 N IN 47660 -- - - .- . --,... ' 'rA<S'L it " - - - -- FH830053121^, 2 W 274 SwvareaNraeFuaa Seneca Limuw: • alkh . - 27c Unease nber(OL -e• -.+,•,,,,,��t1,, '--11 JERRY LEEBASHAM-/BY ELECTRONIC SIGNATURE.n,n cVai' ' _ . IFD01016589.,.,-' e'vT,ii ' - 33 r•Ft .*: sir tam a Der (See beosetlale And Exempla) - ry;alea��E�i{r ... - -.el. ApprmamWe fTl N- 2fl Pal L Biter The Chen a EKRN -Diseases.rluies,Or Campfmtio a;That Dad&Cared TM Death Do Not Ester Tamra Everts ,�1^ ,. - 'aenat Oases 3I PAP )Sods As Cadge Past,Respray rest&Vara:t r Fixation V,BNat Shang T e Etiobpy.Do Na Abbreviate.Enter Only One Case On, ,�h To Death -D 0 Ali:. Add Ad55mal tine tlNeaaisary. vry.1�,4�1=' - r-� - .. to 0 amaSWe Case(Frei Disease a Cancer Rastlry noeah)f''1st A DEMENTIA AL3NEIMERS n..o...re.ems1 6YFARS- _ v • 6• � Seauaeiaay Lm Caicabons. If Ann:Leasna The Cause Listed On - e . - ` ,i,:04140' ..n?�.`*Y.1`f`r W. u seA Enter The UNaneg Drum(Disease atriay TMa frtete yR� I - t'- ' 1 • The Ewes Rending n Death)Lin +' C as "J�i l:'`4• r. 'l r Ct t' , ' ) iy,LgzEy •4t o.eror.d.wsca yT�,n_s ,rap r 4 Paabar Ona�^'t� _ l: C*+arN Pet 29.Was M Autopsy anmrlll r El ves 0 No ' .....'1E I .. 33.Were Assay nag Ayaaae TO Omelets The Cave Of Omar Lti, HYPERTFI)SION ,, WW 55 s ❑yes Np j`l 31.Da Team Use Caatla To Dame. .,} 32 _ ot't..,y'Ld b. Maas a DOh - sa�A (t 0neatrm.porn p'.ey-ern are se.aDas 1:3I Hasa p Lm.rie. ❑ANd.e 0PeNrg amtgam .3 ❑Yes 0 Probe y El No 0 O+aa wi_..' AH,T YV t lryu by , prnw:trl,a.a 1 s arnoGe� ❑I��rwsavaemres n. ❑S'a3ae❑Nara Na Be De4mheC 1RtS�t(�" -• sal. a 1yW(NaasDaylYesO V' 35.Taw - 1 U10 36 Race 01 Wry,r(EG Deceders Hall.Canavan Se.RWaaa1133be Ann) - STAaryu1Nat? t4 `<y4,.. -' -..n'4;tt . C"�. y14,41, - 'tDyes -0 No ( .3B.Larsen a Airy-9n 38a Ctya r t .i IU 3BC API-Lb. 3Bt rp COde:.__ �� 39.Dewlb.HOS ra+y Orono yJi, catcs' • :: - i uTra�,p..,.�;pm.w.un y . J.1 a.Scnela.a Person Cedar Cana Of DUCT., - - .- '' SP�'s"' - Q. CestIIs (Check Orly Oft.) 44.10P7'..- �_,• , TERRY GEHLHAUSEN 'BY.ELECTRONIC SIGNATURE �� .r•,�QbRY9) - -I ®C.Myrg Ft dSaG ❑tpm.r - 0 Heat Cater v (t 43.arra Meta AN bp,Coosa eau:C.rMaOF�n.� , '"' :,l •; - - 44 as-we`.aee` • Ell - -TERRV.GEHLHAUSEA 1020 W MOF3TON OAKLAND CITY IN 47660 02000730A 01/24/2018 'AI G ' s •�Art' �j- \• ) t a a.- ,._ e.'•-' -j - 1 s- e.9:Fa tLpNer Ocey orFia(MmarVDrylYV} L4 FC I.a sena,eaLOVmm,amyr r BRUCE BRINKJR LVIA ELECTRONIC SIGNATURE Ap@ '%" JAN 25 2018 nsSt.=. �' 3i W_ •. 1 •-AMENDMENT 70CERT1RCATE OF DEATH(ENTRY OR ORIGINAL) 1 - , 11:14 S . - .' ' 1}R".1,- ltd L0, L C ` 1 L1t t+ �t } f`• a ' 1}' `�b -1 J4-all -r,o%o 4;az-'OOco - i� 1. - iL 6.v 'Stare' Fan 533% ATTENTION ESTATE:The Saar Seam s s bang requested by pis ate agency is cater a puxe respunbay:D"erban s va.ttny•-•they to be N pay for rahnd%y, )a W w p 14'11 ORIGWAL'OOCUMENT TO A NULTICOLORED BACKGROUND ON SPECIAL WHITE SECURR'h PAPER AND THE GREAT SEAL OF THE STATE OF IIED. HN flock THAT - - Fi R IN l7 TURNS FROM ORANGE TO YELLOW WHEN RUBBED.ORIGINAL DOCUMENT-HAS A HIDDEN VOID ON FRONT THAT APPEARS WHEN PHOTOCOPIED - '`+ • r.•o%•,172.;Jn`""s-sr•`�.)( -v..- 4xc-a 7;STATE^:OFY INDIANA`. Z. --)._��°'„a r y