STATE OF MICHIGAN ) I, ANNE B. NORLANDER, Clerk of the ))ss County of Calhoun, do hereby CERTIFY COUNTY OF CALHOUN that the foregoing isa true and correct copy of a document on file in said County. Signed and sealed at Marshall, Michigan wD sv P2 Blah ml? ; BV eebenclar) oa ANNE. NORLANDER, COUNTY CLERK , oF Oe, ike, He CR Sa Prily Clerk i STATE OF MICHIGAN NOUS erso eCeet ‘DEPARTMENT OF COMMUNITY HEALTH. STATEFLENONOER CERTIFICATE OF DEATH 518363 AMENDED. ch920017 T BECESENTS Naa a a PoMteor smn [SEX — [conor BEAT Cee Brianne Erin-Sheppard January 06,1992_| Female |Onor ARer July 03,2016 RANE AY BRTTOR THERON USD FOR PERSONAL BOSS ADE assy [TNE SUNDER DAY Cree Beanne Erin a NONE DAW [HOURS | NOTES # | jiocmovorsem [RCT LAGER TOTP SENT — FECOURTY OF BERT 4) Siamseer or ass nee 2) RoRETESORCE AE Oo fevocaary SHEET NONE Michigan Calhoun [Bate Creek iar COTE TENCE Ta SOCIALEBSIRETY i DECEDENTSHUCATION 4901s Batle Creek, Michigan Highschool graduate Black AbseaneAmerican, Native American Jouan’ [erwep roncesy ‘No No IR URTACOSEUPATION FERRO RRS RUSTY] WARTACAT— NE OFT OE i Factory Worker Menufacturing Never married SPATS WET NOTES FORE PET WARTS — TL (REE in ~ a eco RRNA TODO AN ADDRES Tey Mees Bale Creek Michigan 45017 i [eer SSR 2 MENOOOFORPOTTON 5s LAGE OPDERCETION ak LaCATION Sy Burial Oak Hill Cemetery [Battle Crek, Michigan 3) inonmeonaroarscecrucoea Is GoRSTNaGE PONE secu ee OE ETT | Samantha Mayer Baxter Funeral & Cremation Service, 375 W Dickman Rd, i 4501008019 ate Creek, Michigan 49037 Fa Re REC ORS am ONOUNRD DEAD Oe TE RONOINEED TEND ener ine Fi ie July 04, 2016 00:50 Miltary Time PS REDIAL ANENER SS PACEGE DEAT LF OSRTAL | Cue 3 Yes Otter Residence el Wieececes “jessie NN MINERS OE, NANE oF ATO PAN OPN TAT RTE "| uly 04,2016 agotroszot | wie-se1 ] scNae wo anos oF GYROTTCn “Eine A Deg MD Cau Canty ME hn 10 Od i ae MO Dal Ce Mp 07 HRREOSTEARSSHONATIRE tne BP Orda SR DATEFILED July 20, 2016 a gpa a rai [Sivcmocrac bi es rena oo SAes*T7—7& tand uterine perforation status post carly vacuum aspiration and intrauterine contraceptive i evi placement ZS > H 3] tac, over sonincnvt CONDITION cago tal a mt aig TOT Prop roaeo ie SUPFaRLE Denna Jcourcsoretovexrn |'Ch serra 5] *Methadone use + Yes O potty | C)rementoncis BND tam | Bremer SANGO “Ge WAS ATAVTORSYERTOREDT ice WE ATORY PROG AVATABLE | 1 Sarno | ion To COMPLETION oF cause OF DEATHT | Ol Serna Accident Yea Yes Op eee Ti DATEOR RT TTR [ac Dace ow RAY OCcTRRED ‘indeterminate ‘Unknown —__|*Use of unpresribed medieatons fl fi] bnowarvon Eeromormay —[iprmamorananay [ue ee #3] ‘Unknown [Unknown ‘Not apliable unknown, unknown, Unknown $L01179265 VOID WITHOUT WATERMARK OR IF ALTERED OR ERASED.THIS CERTIFICATE OF VITAL RECORD CONTAINS THE FOLLOWING SECURITY FEATURES. THESE SECURITY FEATURES MUST BE PRESENT FOR THIS TO BE A VALID, ACCEPTABLE DOCUMENT: © Watermark with chain-link design © Fluorescent security fibers © Full chemical sensitization IMPORTANT INFORMATION: This certificate is a valuable and legal document. Please keep in a safe place. WARNING: Obtaining andlor using this document and/or personal identifying information contained on this document with the intent to’ defraud or commit another unlawful act is prohibited. (MCL 445.65) ‘A person shail not willfully and knowingly obtain, possess, use, sell, furnish, or attempt to oblain, possess, use, sell, or furnish to another person, for any purpose of deception, a counterfeited, altered, amended, or mutilated vital record or certified copy thereof. (MCL 333.2894 (1)(d)) ‘A person shall not make, counterfeit, alter, amend, or mutilate a vital record or report required to be filed under this part with the intent to deceive. (MCL 333.2894 (2))