Death Certificate - Vessels Jr, Joseph F_4/30/2019 �;�:` r--a �r�lUa lc,, . :..91 ,�� 4..-..'crify&CERTIFICATE OF DEATH ,1:::€ ,.,:rS:+�?a,l.. '. ,c. a: ,.-z,=
' IS\ ' ^I" fl i• . 1, r�l �✓ INDIAN I e r a ,ii/ 'li I ;II I� •� ^�
'1 � �GERTIFICA7e FrDEATH n�
H.
r`� 3 N a r l�,� i ' R il.t It- r l Ti •
a.• _.oval N 000274e� EDR-N1�o 000000421368 testate No'057581.'
it r ./. r..e.4 1 _sivl� it !';>iiinwitl //I ,1�1/`J<IMewesitm.::a-��1!�. ��`,,�,ii II�1.17?I f,',�3�1�t��: G.. :‹,..ti ��1.i�' J I°Y%' •I' .
} .JOSEPI F:.VESSELSeJ-R' ,. � s•?;\\= : � iC \ iC�MALEI‹:.... 12:00.P � <�12119/2014E i
5 Seany Ahmner Ba"Ape Yn: fiD UrCer l.Yaa 6c-Lhde 1 Mmtlz ed Umdr 1 Day/ 6eiti ' 1 Hair ]rOta of 6vtti:(Yor VDayA•ear)' :8:S�f,Glace"4CRy and Sax o Fore,Cazt)�Yl .
C j �``i�� / '' Al\\'. z/iaH n` :/�i�\r ` sAlui / .rt: \W ,;..)E/�.�
races-tilttd It Dead,Oconee In A'1lospital /: I r / I /il per/ it /O& uomtom,reds«,e«•rereomer TnanAHosp.ai' 1 U II II" , t ! ✓-ii
� �� ✓IIII%JI �JI: ��II I�.
it
� `y ��4rva� � v C \`��'iS '_t�•is A7 1 p?1'.; Far..IrC�a •i ,--• Hmx �®Nras:v H«nw-orwWrmcue Faac�'s. y31 �.
i v \iD•' �: _•a
;j..i ®resip Np p'urR„o«np iroarar.O em.pa+rroawrpne�wzt.,er+,p DaadonAmi rp-oa;«Isca*n..t. - I`I� Ivl�� iR�1��/"1�y- :.(..-
y` vrn:L i .Ntmtm✓ l %i:nlC- -tl C/ia I V".. .n / tvi r - ,cue .... ✓s.4, ✓ I e
� sdt;:fst8tr Name-OINol trn-u00:C'w Smm and Noroe�\i 'k,aC\'1j 'ice -�`�y[&,,t,!`,/ ✓•.A,r Ei :1(f `\. -.n r! ,K Zi. r '`it✓Ct
Tr'r ti TRANSCENDENT HEALTHCARE OF OWENSVILLE�LLC� .Z.t..r\.>�t'`�� 'i`-. fit" �. � S L\ �\U i \,..,
�tr 12 Car Or Town,5a'i A,tzq Code li 7- r:.01I97.. Ins IT.% I i l 1.133‹Cwa.V.1 n�,N ! i' r �i vs.
MantrsrmourrndDra-t jest,"..,;;.
,t 1 rn:�U:'e�\;.a 4 v .\ y am .N�,:� y s G‹ �\ ' \ Y� �e� i i •®w,dial Mamee llseomae�e\f p�l
OWENSVILEE;:IN 47665� ii? r� v..•lu y ,t • T/ LI it-il GIBSONl, / ':it ts.a I; tD'ASdoe°dn,.O Nev r_am°d.p u*1n,
i.
?P1'1 t5.5wmngspouses Nacre Crt f e •ttf� 1. e..< 15e QLWkKirve Mde.last Name . / t6 ;•:.: ,rts Usual Ocamenai•i. t,17 Kt,dd E6ssv,essdrndmny�<J
n e i Et�rlli,��1 y/i i}I ~ice 1 II z%" '}� � 'Y `Y. i' .4 Ny✓i�1 (t♦,y�lh i- \ t.Dus.tt �R~
LOIS.VESSELSftl /;. tt✓ .i •, w e iL EMGE„.,, S�.-a .r/.! E/ If�...ill MEATPACKER I" �n FOOD INDUSTRY i1I I
t t6'Resi ES Strom. \ l \ \ .ttea Cou.---' , )+` i..7... tBdNGY Or Town\ V' `�,� \\\�tC i -SC'''. mil ' \
3n i�'..Ilrtt/,}(I yli } ;![ ���I�'rAlll r., tY'' (Y `�it✓�I IIRY-'14p ft /�i.?/ T.ir��1i1 t 111 `i. IT
)ji INDIANA\.1 Lc<�`L�\vl �\. GIBSON e:. •t. .•,lr FORT/BRANCH '-u .6- r.� iv tll n cl.l •o 1., 1 wei,c�nsid vo??l
e 118c''sneet and Nuncery -•' �Ii 1 t\f. '\ : �`J.iraw, 'i.rF. - d?ted AptNcyll tee.-Z Cod.'. TiIC•ImdeCn .111!„
UI;G r) I% ,,fII4H✓iJ ie/ II / '� / r / ri Ii1i1
TH /Li "e.�i n Y 'r it L I .%IIIIY/Cy. 's4 C i) E.• ®Yeslip Nola:
��-j 504�NORTH HULL STREET3ydr.� �.,-_ �� < p'< �%;n'. _� " .•'`. +\\i47648 �.\\1�i�.
t 1p9-De SCHEOO GRA�DUy,l%idli GED .. 2O Dec.eentO Hspe c• On,. :V�r - -tt ,12•M c Ra" I,.it I I i,...,%ri 'c 11'',I'rY�' It��]1,.
'l^ COMPUETEDry4_'t•'t J>/_`T� r ..?r NOT HISPANIC ±✓`in�.tr . Whlte: ddeto. > :�r�•t., �' . i. ;:v t io\.. \
Zl FY'ers Name(Fust.Mdde'last) I I % r ,f"F->' r/ i' ,- :t! 23 MW Name(Fvs['tAidde LnQ c- '" i r 23a Moth sMaiOen Last Name / tic-'
rP�y�� �i �/L `\ �� . .r Vi \mo▪ t' � i l ^sus �, mat 4 r/ 1 /
JOSEPH FIVESSELS SR:::: :::::"...:!::: I�/'. L ;✓ ' IIbeI "� CATHERINE VESSELS �� �-,/I -✓i I YOUNGir' i : /I h��
/� 26 I:•cc ants Name- C AF Ly'I 24e RM akp To Oerederd Zed Ma&q Aaaeal(Sreet And Narnner.Cay.State.Zip Code)4e4T/ I ▪ /' Atli✓.
C ' LOIS:VESSELSi:'.✓�ti-It.l., t% - SPOUSE ai.. ../iiri 504NORTH:HULL•STREET,iFORTIBRANCH;IN47648 /•:...tzilu•111Ht.
N -\jF SL-Cl po&.a 'a�lj' 4.�'\a -� V 1c4t,ispoeson n.OfCaaa25 Pla oatxy.Oted ace) :2.1<cetc ,Cdy TOMv-Ast �Ate' ,.>I- �i`�--__4 iI�
Q imaW1mdaspozona✓ IIF( !rtt lif 2sr PwpedpsP✓wlxn ia571 cnma11 tj;;;;ce) •2x m�a cur T;:!.i COsx.; ;'iI ?ll 1�j " 'Q''/J.i�IV lI
CC j l]er”.al p.Drer'18'XYI❑Dauwn'®Ercorwi,am �rli IIII ` �L'i f�I F tl_ `%, r��t7'F< vt- y t-h Y/i I / i r�
W 2 p:R •al From s"\a•�' _ �� I min\w,tti.�� .�\�'� �\ 4`�';`�3'� >,3 eve ` �/I
p'ogerll§"ceirill. it 'lii HOLY,CROSIS.MAUSOLEUM !.. /Ir. .//,i FORTBRANCH INIit;.i'llt;i. .h /.al1 it'f2n
Q 25 Was CaraneriCoreated'? "- 2`l�e AM ComeSCe Address OF F+uwal Fa llY' c- -t C- `\ � .Ir.ii... is i ,`]a Frnral Norte t ae�.dar.
a 'ti'r j- '-"'Zilt iat L W'-trIi .✓'. trC r l.6<1"'(;s'/'rl`:. }i b `s"CH'I ��It� FH1 /iit ' i
W �.citl.�+ll : STODGHILL^^.FUNERAL=HOME INC-500 E.PARK ST H�WVY,168dFORT;BR, ,.IN 47648F/oniconsee..1 FH70�9t0?�0.0.1,. ,... l/.LI
W CC Y;2rogD,anse CI in"fe,e< Licnsea;EC_TRONIC'SIGN\y?\E7 jC : 1tFf ll'F%Il: F.D214000005:'.IIL' Crr 1, �/�;f �ilti lRrr
ANDREA LYNN:VINCENTLiBY ELECTRONIC.SIGNATURE/I ti%'
J �, ✓ v V aU rcauseMeaMlSo,lnstrucibnsAndEsamgesj "41 ,- tr....„
c e.v r✓ ,y
J26 PanI Enerlhe Chain d Eventy Diseases-,truries -"AComplrraldm That'•'▪- --Causetl;The De▪anne Not Enter rderOrnuul CaLse / /r IIY,erval Omet�r
... . .. '- '-`ibtrevak Eniter Ordr One Caiae On 1!' / (/ ;� i'�'// To'DeaN'�•.�
— ' A Lsiet'Add Ad6lavl tares .1✓ F,`,j/'. . . t - ,T e�< ' .
tinmeda a Cause(Fowl a ?kiij ./.. IR/ R�'/ L / l "f.! r> /8�2 YEARS"At,
uo ?- Fi I r,C/' ^\ `� .c7j�1t�E/w to `" w• `.v of /Cj .J.l ;y�y i✓ I ice /
r+ ur• iwa i,. ,.-4,ms. V I ``\iY'r�1a .s*4"� \�V vim \4'\\:,� \� \
,. yLne r.rEntr TheU . - IIF% Yf_rilr/:II cdIlrii'1,;1 k' !sue rl l.'�i�J'''' .
iris Events Resrking In . ''' �7. \\"vri r.�i ..-.. „L.,.....„,
t\``�'
1 ���,��a tl' v / ((t o.u,ua ta..oAoo l f.�✓.I l C •it.r/Irk%t t / Rs
\11Partll'Fxer Omr5t6T!amt • 1 rta2- 29.Was M"c9"Pedm'ea7 1r:V �v-/
Its/ r l•'il il,l t'/ In , e ri /, d� p.Ves aiseONOIY/Ii t t t
i} v!Ci / i l Qt /`� 30'Were Azeopsy Fadvp Avapada To Complete The Cane d OCa C , < •*4
j RESPIRATORKFAILURE - \.`/L ire. -zSsa- `+Sii oral tiFsi `VQiiMC7....7.p•Yes, p.No.
/vrt.a,.exer,t•.vnC�r ' 33 Mamrd Detn r)�.J31 /Cx/ eUu1
N'I J� //, 1 / Nip'Hmme ❑,AWda pPmdup
lmJ
enpabr
\emu ��v ` \ ®p5unp.CmOe -Nt`.e DWgie/d` \ C` ;C p,Y .pPmeabE,0 -
��33,Yi t:W✓"T JY,r:�3:
"l' 3a Des dInjury(MaEYDay (EG Drxdent's Hone Cansin,rdan Sce ResWuarnt Wmded Ana) 3] IrEt Af Work?
Sln / < ' \ ,n/-. alls'i,li S ie 11 y:2 N✓ily Y/ 11Yj:II i Rill/ Il . a,.�:
al t Ivl C .. , CC cr ir`�• l�G .t p Yas Z p No \
f? tti.'V�i FnU�".f!: O ✓� '�\`\r v `�t. Y \s.w�\b
/ mlxr GG - Y 3ec Apt NO I ,38d ZIP Coca /
,/{ .V3e��'�orau,nylryuyi sax : r !'. ; i; Ia Y I �!^t, f/L E/ . 74L �.r�
l „„.., . ..<.�~ Sty c<. xx`� .�iJI 4 t P T
csoee�i rt vn ✓ �E\L- C-� \fit'-,j/ It .to tr /ire a N ✓ / .
e L3�9.`�smee�nun' \- + I ��y..f"v.. 40I II tma-cS LI°.,.�.�plm:Lsa; `e`2 II / :i
> 3T %... V �\/lin �t�' fr v.•l�\ \J .T im \.y°�r .iY''w
r 5�,,(sgnayn dFerspn tlr'i az Cemsr4ciee,a=$Dr r ^I r4n1Ir-!J r/i''I!!Y/
` . LORRY WILLIP,M LU. uk'3 i , 'v1 ®CerdfpnpPryshct 10 Cororw, ip HetiOCm -..
§ Q• l
`` eat Name Address 0.•d ZpCC.... .T'+. lit
% F"• ?/Its N � :- a5-Dax' ..".•�)ww0,1 i. s�j\ aL,y v r .. rli` i ISJ/ I1 Iz' r .���I)���� �`.Lvacvu�.tr%.caLrtyI / / y ✓.!�nl%y,ttG ` t� �iu:l ✓LARRYWILLIAM LUTZ� 0.2E OAK ST�FORT BRANCH- LN: ir _ i 01027538A `:\ 2/22/2014.i�� AdanoalFuwal semte Prader- /,nI yt%CI lv p r.•/ n L1j. a i (gI� p t ( vi-.H r n(. les I'F.glr lE%gl•Y�rL tr•,/•;1!! it}I"P/f �iVJF:`.'14s. tsema i\iVhllI �Lr .-JKf.�aV�'C ga4 ..:g,J-) — :1�"��.c�uit' W C/C;.7T/.-Ce1iec ./�C'2II G:C 4i1
a;.-.:...tar E BRINK JR�VL4 ELE TRONIC SIG ATURE �L i' /r'l l I i I J:IIC�-Jli itif..DEC 22 i1 /.1, I ii% .I �i _,--.r Tri'• uii-i 1eJi r r; I 'Pelf
\r t1 �iv^e\iey�'�S\1i.•�`i\1y\\y`I •.. S n�y AMENDMENTTO CERTF�4c$RO24Qt RY•OR ORIGINALIt,C\ \\�5t^\\7k4' t.. ..-.. �.\ 'rlt\\`
'c.. ill-t-% e . / I illy i;l 1 I I 1 G ', I; 1 ' ▪ Ir,.. _..
E: j •i ��I i � I �� �1i �l ?:2' ii�i Li< ��t _/���. +!!mA ✓ i i i
J-'.c--T i 1 \h. Y i t ✓ - •ti•z CJ �i�z"' \V \`cJvTn n.+•. /' . .
L .i Ii1 -i/ f �li: ��' �e rr 9 t n-,, all t./'1 f( .- jam' ;' /, /.�Y� „rt{.
, -5: I a ,'} � 1. I i I �j ! -Ai/Mk I �-alit✓ I J I r �./ %.i ti
</i 1. (. �; �J �`3 Gt$SON GOC1N : A,101"TOR� � i "'T�-
'I' tl: i- /I / / 111 t ltt / i146t Utry Hl tltrue:ln!/ R ✓1 ', /T . t t th A
`tea„,...fam„53395 AT�YEtTUON ES PAE O0CauaNS?o,rd AMUL n8•re9uastad .fi ROU1 Dpe-sirscIAs�� Ectikf.raRE 'freE GR An" EEL- �vSTbA... tq S'/N ONB
yr�,s\�yz,[� 1 ORIGRfADDOCUMENT'HAS A MULTICOLORED BAaoRors_.ONSPEGN. IAS Hi ECUWi,..„..H'ANDTHE GREAT,SEAL OF.THE OTOC F.Ijt01ANA ON RACK7HAT '
1(F•- `!WARN MG.'iTURNSFROMORANOE,TO YELLOW WHEMRUBBEO.ORIGiNAL'-0OCUMENL114S NIDDENNOIO ON FRONT.TL(ATAPYEARE WHEN PHOTO COPIED I,ItY'./..11 ?�.