Marie Innes VanWinkleBlair Cemetery
Blair, Nebraska
Permit for Interment
Complete the Following
Number
M
I hereby authorize the interment of
Marie Innes vanWinkle - - - _ - - -
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in the lot and grave space designated above
Signature of Relative or
Legal Representive:
Daughter: Dixie Szertwitis
Address: 820 N. 88th Avenue
City,State: Omaha, NE 68114
Phone: (402) 391-2517
Marie Innes vanWinkle -
Name of Deceased:
14, 1920 Age - - _
Date of Birth:March
_ - - -
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820 N. 88th Avenue
Home Address:
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Omaha, - - - -
Place of Death:
-Nebraska - - -
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Widow ed -
Marital Status:
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White --------_
Race:
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Cause of Death:
mending
May 1, 1996
Date of Death:
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Date of Interment:
May- 4, 1996 - - _ _ -
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Dixie SzertwitiS - - -
Nearest Relative:
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Block 983 Lot 94 Grave 411 - - - - - - - _ _
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Vaulcoa SterlingBox: Tent:
Vault:
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-- - - - - --
B. Roeder
SIGNATURE OF
DIRECTORJon - - - -
I hereby authorize the interment of
Marie Innes vanWinkle - - - _ - - -
------------------------
in the lot and grave space designated above
Signature of Relative or
Legal Representive:
Daughter: Dixie Szertwitis
Address: 820 N. 88th Avenue
City,State: Omaha, NE 68114
Phone: (402) 391-2517