Craig W SaylorBUREAU OF VITAL STATISTICS
STATE DEPARTMENT OF HEALTH
LINCOLN, NEBRASKA
DISINTERMENT PERMIT Na
Application has been made and permission has been granted to
Craig..W. Saylor...............................................................................of
Supervising Funeral Director
the........Campb.e11-Amii?.... une.x..7... Home ...... F ... 0 ... Box ... 5.0.1.............
Name of Firm and Address Blair NE 68008
to disinter the (body) (bodies) ...Mi chae 1••. Chr i ... ocher ................................
................................................................................................................................................
Blair .................... cemetery in the cit or town of
now boned in the ....................................... rY Y
Blair ........................ county of . Waahington.. Nebraska, to be removed
by -Private Conveyance........... to ......... Blair ..........................................
cemetery in the city or town of .Blair .................... county of Washington.„•„
state of ............. Nebraaka..........................
I HEREBY AUTHORIZE THIS DISINTERMENT PURSUANT TO THE
PROVISIONS O NEBRAS REV ED STATUTE 71-605.
..
y
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......................................... .. ..... „r int....!c"..& :p.
(Si tore) Date
DIRECTOR, BUREAU OF VITAL STATISTICS
DEPARTMENT OF HEALTH
This permit should be retained by the cemetery where the disinterment takes place.