Death Certificate - Satterfield, Robert_8/31/2022 `oi r4 ." r:C' (-:,....ram•' ..'�c a�i# 40 +lTy ' •la11 •ii- '-- R+.K•11iWIPN -.-"n;.>-,r11 :%
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;< +r. INDIANA STATE DEPARTMENT OF HEALTH 01
4 e :Vel CERTIFICATE OF DEATH
Local NO 000023 EDR No 00001191vaaA5 State No 2022-009751
Robert E Satterfield
0 NO.8iae Feday ®D.mdwri Hone 0 Nosing Horrnitcatowna Dee FrAV
i1 ❑Yea ®No El uramo.n ❑Spades 0 F+•rero s Depa nm .�d an'4 Oe* 0 Dead on Aerate ElOa,..(spa dr) �)
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11.Feeler Name( t eau+.Gies Be and en a Number)638 E Water Street ,
l� 12.Ofy Or Town,Saes.And$Code 13.County 01 Death 14.Mesta @weer At Tina Of Dean Gibson Maee.d O ut..(.d.ea S69 8 su Dho ten
i-s Princeton,Indiana 47670 N trelda..O El H aw Leaned ta+oo .�
wn 1
10 IS.B.t•1t�ato(poemere Name ISo.Last Name Before fist Mange 1B.Demean.Us1ta1 Ocoamloa 17-nee 01 Bu sin essandue by 4.))
I Coal Miner Mining V
b'i16 Residua•Sate 18s.County 180 City Or Town
IN Egon Princeton A
lad.Apt Na. 18.-21p Cade tat Slade City Unita? k
e� tsa>;E Water
ter St r 47670 ®Yea 0 No V
I.( 638E Witter Street
19.D.o.d.ttr.EdueaBon 20.Decadent Q temen to Origin 21.Decedents Race - •
High School graduate or GED completed Noter WNW ?�1
'.' 23.Prim%Nam.(Fist Wd e.tea) 23a.Pessnre AC Nara Babe.Fist Mereede y}
► • a 1'aents Nam.(Fin.alidAt.(AC1
?< Lloyd Satterfield Rosalie Satterfield Coomer 4_
Om 24.ann done,r.Name 24s.Rabtlertstip To Decedent 240.clang Menem(m And(Street A Nutter.Qty.State.20 Coos) •
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Jason Satterfield Son 600 S Stout Street Princeton,IN.47670 •
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CC 25 Race 01 Dom.
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LU ®Budd t]Qertm7on❑Donaenn❑Entombment
.p r4.ale.m r1.e1 sue Co(umbfa VVtltte Church Cemetery Princeton.INp,
p u I' 26 wa.Coroner oarro.dy 27.Name And CanvlOmn J10rrms,Ra.err F11efaY 127a r•1.wa Hem.IleaMlaanesr: a
Colvin Funeral Home Inc 425 N Main St..Princeton.Indiana.47670 1
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Cams Of Death Mee kaErtaaderss AM Et emplee) " _,y ,,
u_ I�' u I Or Complicate/One-That Moody eattaod Te m Death Do Not Enter T `/fill at Onset .
ll .•i i� 25.Pert I.Enter Tin Otmaeaa.triunes, On To Death -
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Ad ebnal.R roc sary. Or Verd+iaaar Fme(B�on W75nut Swaim 1ho Etiology.Do Na Abbreviate.Etvar O^h __ G 042
•,�;:lln A LJee"addo ao(Fined
(laced , Conde Chronic obstructive pulmonary disease O `�. ` unknown er
• immediate Gaut«( Dlaaeae Or Condition Roaul4uy fn Death) A. ny�p.y A /���
Cerdla/aswter O�ti 1\ unlalawn :�
Seglmrldatly lad Carldaaam.el Any,Uaae,Q To The Crime Listed On B. L>•.(oa.aor.w.o ok '''I
Lino A.Enter The Underlying Cause(Cleanse Or a.)1+)'Thal v�tuea ?('
l� The EvaNs Retwtta+Q m Dash)Lost C. o..0d00 a eb4•4004.404oe
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H(}'� PW B.E,e.r OU.r But Not Neatlrq m The taldrMaq Came Own tot Pert 1 2f1.was An Atdopq P.elarunld7 ' ❑Yes ®Hb
{ 30.Viers Aenopey Fatting Awtabb To e1h.Carr,Decan? E Yoe 0 No :'
`c(! ,Il 33.Mama Q Death: )1(
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t< 33.T1ms,trway a6 Pate Of away(E.G..Doo•d:.L Htoene.Oomna:dan Ste.R.Ca.a.,Wooded Ayr) 37.6$o Al wand \ 1
H 34.Daft OI ems),( Yeas! 0 Yes O No Uri
3a0.Street 8 Number 2nc"APL rn. bad-Zip Cod. •�r5
36 torAaan a away-steo boa.CT(y a rows I l 51
+, ' 40.OTC r Il.m.i Seery,Specify: iI
j. III as P.aab Ho.nw.y Oaoaad Oo..4.ase Or...e.Elesaasee❑oe.ta.w1
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41.t➢perao.,Plant Cer4t).g C.1a0,Otaac 43-GaiOer CChysican Qe1O Gorier 0 H4sath Orlon ..
4 �� 7 f Beetronim9Y:3kF+� �l�n I
Bra 44..68_ tie Macaw 46.Data Cabal �./l
'1 as Nana.Address And av code,,Pence Candying Cause a oe.x _ 1- 020 r Mac 02/14/2022DemGen
Bruce Brink Jr 410 Morn(Mein Street.Princeton,IN 47670 J"(�
-_ 47"'Asia:' jJ`
i 48.Adduced Fow.1 BsN=Rosiest.
4,For R.pbar Red.Dees ed G >w1t teeg1Yw1: ..,d
(Bruce�sutk,r Health ot>br CERTIFICATER Electronically Signee ' -. _ _ 02/15/2022
AKE OMEHT TO CERTIFICATE OF DEATH MOM O OR1lYNAL3 . P)
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f • State)'von 61995 ATTENnON EST lE The sold esewsy f is roasted by Yio slab money in adYbp pursue
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WARN 1 NG ORIGINAL DOCUMENT HAS A MU1710000RED BACKGROUND ON SPECIAL WHITE SECURITY PAPER AND THE GREAT SFAI OF THE STATE OF INDIANA ON BACK THAT C
~, . TURNS FROM ORANGEr l v; �MWHEN�� _ORIGINAL DOCUMENT HAS A HIDDEN VOID ON FRONT THAT APPEARS WHEN PHOTOCOPIED. "r v^� ."K.a