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HomeMy WebLinkAboutD-1558 i " ,~ '~ . , (I .G\. CERTIFICATE OF ACCEPTANCE ~~ 03670 r r 780 This is to certify that the interest in real property conveyed or transferred to the, City of Arcadia, a municipal corporation, by the' deed, grant, conveyance or instrument dated ,Ma.rch 17, 1966 , from or executed' by R. IRVING McCALLUM , is hereby accepted by the City of Arcadia by the order or authori- zation of the City Council of the City of Arcadia contained in Resolution No. 2963, adopted January 21, 1958, and recorded in the office of the Recorder of Los Angeles County on January 29, 1958~ as instrument No. 3069 in Book 56448, Page 64, Official Records of Los Angeles County; and the City c dia consents to ~~~~~'or by it, duly aut 0 f1m~ . i ty Manage The ocument thus described is hereby app oved as to form. ~~ U City At orney N I --.-- -'W' 'W'- 2882 IJ- /5"'0-' /"~' ilECORDED IN OFFICIAl RECOROS OF LOS ANGELES COUNlY, CAlIf. 45 ~ 2 P.M. JUN IS 1967 RAY E, lEE. County Recorder CITY OF ARCADIA AND WHEN ItECDltDED MAIL TO I City Clerk NC;lm. Sff'MIf P.O. Box 60 Addr... CIty & Arcadia, Calif. SIC;lI. L I ~ rFREE~A 1 SPACE ABOVE THIS LINE FOR RECORDER'S USE MAIL TAli STATEMENTS TO I City of Arcadia I NC;lm. Slr..1 Addr.u CIty & SIClI.L AFFIX I.R S, s...., , '" ,IN THIS SPACE Grant Deed TO 405 C THIS FORM FURNISHED BY TITLE INSURANCE AND TRUST COMPANY FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, R; IRVING MC CALLUM, a Widower hereby GRANI'(S) to the CITY OF ARCADIA, a Municipal Corporation, an easement for public street and road purposes, to become a part of and to be known as Duarte Road, in, on, upon and across the following described real property in the City of Arcadia County of Los Angeles ,State of California: The southerly 12.00 feet, measured at right angles, of the east 100.00 feet of Lot 146 of Tract No. 2731, in the City of Arcadia, County of,Los Angeles, State of California, as per map recorded in Book 33, Page 29 of Maps, in the office of the County Recorder of said County, Dated /~~"",t. 1/ /<7(.1; ~~~L- ~ . rv. ng McCallum . . STATE OF CALIFORNIA } COUNTY OF LOS ANGELES SS On /-1' ,~~ ( / ) / f' t ~ before me, the under. signed, a Notary Pubhc In and for said State, personally appeared R. Irving M('c:~ll11m '... . to be Ihe person-whose nam'" mstrument and acknowledged that offiCial seal is he . known to me subscribed to the "!~thll\I'1 . " executed t}u\)sa4J4 C . 't../ ; ~ . ' " *. ~" ," ,;t *!I. 0" "r, .: "" .." ' f/J r, ~ . ~. . .","~'. ,~:.. ~, JC ;:..:: .. '. ",-,\ \, . C~~- :. ' .~;~:: /~~ t~: ;(~~\5- ~j , /..'...;,.d'.~.,...... ~."" ~ ,'.' ',. :. "" ... .'~ ,~~ '",:~'.~ 'F;~ro;;<:-<ir-'Loan N ell ~ , F?:A~r( H. CLOt:GH My Comm1~~..::, E~j:ir"~ "'\U;j, 13, 1966 Name (Typed or PrInted) (Till' 11Iell. fOI "mda! notulal ..'al) Title Order No, No. MAIL TAX STATEMENTS AS DIRECTED ABOVE 2 (!P _ -r e;.. _.. oil',.. ., ~ ,. - .. '. . " . ..-~ , GRANT DEED GRANT DEED "'It..-. . , , '. ' , . , , . , - , -, r"'.~ ~ I ' I ,- .' " -. '. Title Insurance Title Insurance and and , Trust Company Trust Company ~. ',," ,- 7' COMPLETE STATEWIDE TITLE SERVICE WITH ONE LOCAL CALL ~,>". COMPLETE STATEWIDE TITLE SERVICE WITH ONE LOCAL CALL .' . :-.." ~ T" '..... \, 8' , , . . , , , . " . IV COUNTY OF LOS ANGELES DEPARTMENT OF AUDlTOR,CONTROLLER J, R. PASSAREu.A, CHIEF TAX DIVISION 153 HALL OF ADMINISTRATION L.OS ANGELES. CALIFORNIA 90012 625-3811 December 19, 1967 Direct reply to Attn: Eleanor Parker Ci ty of Arcadia 240 West Huntington Drive Arcadia, California Attention: James A. Nicklin City Attorney Re: Portion of Lot 146 Tract 2731 acquired from R. Irving McCallum. Recorded in Book D3670 Pg. 779 of Official Records Gentlemen: vlith reference to your letter dated June 21, 1967 I taxes have been cancelled in accordance with Section 4986 of the Revenue and Taxation Code. This cancel- lation was ordered by the Honorable Board of Super- visors August 8, 1967 by Authorization No. 80330. Very truly yours, IffiTIK H. BLOODGOOD, Auditor-Controller 'I ) ) / '-..,L---""'~._~-...:.{./{ ~c((,....,-~. Gy ~,R. Passarella, Chief ;d.:{ Divis:i on ' ") ~ , 'T-'!',,,/->- v~d./.J....J.1. \.Ie HOHE SAVINGS AND LOAN ASSOCIATIv../ P. O. Box 3703 Glendale, California 91201 R. Schoepfer '..J ".- Recorded at the Request of: , """'" ..........- ;"'J , ,I';>'\. Recorded in Official Records of Los Angeles County, Calif. Document No. 2638 Book R2658 Page 535 Nov, 14, 1966 SPACE ABOVE TIllS LINE FOR RECORDERS USE PARTIAL RECONVEYANCE Nll X 9360 WESTSIDE TITLE COMPANY, a Limited Partnership, as trustee, or auccessor trustee, or substituted trustee, under a deed of trust hereinafter more particularly described, having received from beneficiary thereunder, writ- ten request to reconvey, in accordance with the tenns of said deed of tru8~ all estate now held by said trustee in and to the hereinafter described property, does hereby RECONVEY, without warranty, to the person or persons legally entitled thereto, all estate now held by it as Buch trustee in and to that property situate in the County of: Los Angeles , Stale of California, described as follows: The Southerly 12 feet, measured at right angles, of the~ east 100.00 feet of Lot 146 of Tract #2731, in the City of Arcadia, County of Los Angeles, State of California/ , as per map recorded in Book 33, Page 29 of Maps, it'the office of the County Recorder of said County. The deed of trust pursuant to which this partial reconveyance is given was made by: R. IRVING MCCALLUM and FRANCES A. MCCALLUM and recorded: February 15, 1963 in Book: T2851 Page: 651 County of: Los Angeles Official Records of the . California The remaining property in said deed of trust shall continue to he held by said trustee under the terms thereof, AB provided in said deed of trust, this partial reconveyance is made without affecting the personal liability of any person for payment of any indebtedness secured by said deed of trust, In witness whereof, WESTSIDE TITLE COMPANY, as such trustee, has caused its corporate name and seal to be hereto affixed. Date'd : June 28, 1966 WESTSIDE TITLE COMPANY, as such trugtee By WESTERN DEED CORPORATION By............fl.~,.....~..:..,..~,~... County of Los Angeles } .. State of California On June 28 1966 before me, the undersigned, a Notary Public in and for said County and State, pelsonally appeared Hilda M. Turner known to me to be the authorized officer of WESTERN DEED CORPORATION, the corporation that executed the within instrument and known to me to be the person who executed the within instrument on behalf of said corporation, said corpor- ation being known to me to be one of the partners af WESTSIDE TITLE COMPANY, the partnership that ex- ecuted the within instrument, and acknowledged to me that such corporation executed the same as such partner and that such partnemhip executed the same, Witness my hand and official aea!. (t""'-" , ~.j:~\ JACKIE J, C.'\ \'O,\i.1 ,.'ulL.\ I ')., r' II' ~"~'iiJ"''',j~ 1'00 ...,0..1.1... Ct,lI,c.. ,A ~ 1\tj.'~1. ,'::;.: ,I ...l v;.F Ct I~J ~'i; . ' LOS AI<GEUS COUNTY ---~-;;;;~;"s~d;~;;;- My Comm,sslon Expires November 14, 1969 loeO.215A " ' ~, ( , ,:-' ,,) , ' .....1 ' ~ ", :;1,- " , , . '; ',' " " ';."'i: ~ ,~.. ~' y . ,~.: " ,;';' '" ',; . ~' '. , t (;)} : ,," , " , . '.' _.!' ~ . l ,,:Mr. Ros~e HOl~in:g~r.' AU~ltor~c~~trolle'r ,',', , ..500,West Temple,S.tree,t ,,', : ..' ",/ ' ,;L :'Lc;ls Angeles.. Calitornia 90012 ,',', ," .c '. \ " O.J', ' . " .t ,,: "-, . , 'Attention: . John R. Passarella ," " ': ~ ' " ,;, ... ;; ,.'Chie~.' Tax' Diyision, ,,'" , , , ,_~Ii" ; :;>',' . :',::"'..:1 ~,r ,......r ,'1'~( .:~,.. ..~1.': '. ,'~..'~ ,,:,. \" ".": Dear Mr~"pas8arella: ; ,,".;- ", ~} ',::'- -~t..:~ '>',' ,\. ,i'.,:,'" I, f - ~,' '"", ': t .' ~" ':. '. . ':'l~ . .. '," , . . . .", , .' . , ,You' are' hereby reque8te~ ,'to'prorate and cancel ail ' city and, county' ~es' levied. 'as'sessed., due or p~able upon' . ',.. the real' property.,in ,the, County 01' Los Angeles. State 01', Cali- , <, tornia. assesse'd' in'the name of'~ ~~"'IRVING:'MCCALL~i 'as' described' ": '\ ," ',in the e~Qlose'd,:copy ,01' the' rec~rded deed; p',,:, ~ ' , . " " ., " ~.., . r, . , " ' , , . ' Tl,1i,?, prope~ty' was acquired by. the Ci t;. ~t Arcadia by deed granting'an easement'tor p~blic street and ro~d purposes to be' knoWn ,as Duarte Road, and ,dated'March,11i, 1966;',and recorded in Book D3610; page'119. "intlie: Recorder's ottice on 'JUne :13. 1961: . N~ 1mpro,,!ements were' acquired with, ,this prop~rty, " , . t ,', ,'~ I': .." ='"' '.,,' ^ " ,,",. ,,',' YourS,'verY t~1) , ' - I .... '. . ,',' " I" :;' . \. ' " ,,' .1--.( , , ,:: '. (, . ~ ~..: ~, gRl~ilNAL SIGNtD, iy'~ ~ ". ',:- " " -- <:l" ',' ~. ,>- \ " -4 ,'.; ,^ , .' } . , " '(il'" ",""';;; , , "~: . :f~' :::. ~ { .:: , . . ~ . ,:'j:,:::/' '>, "":'" " ; '::. . , .. 'h _, ~~ "', (.' , .. .. , , ' , ~ , : ' " '''/ ,\' :: .:': ..,.'.. ;"~ '~.' , '~ .'. ". " ." ., " " r:'. " " ',' , " \ . i " . " , '. " ': . ~'.: - > ~.~ J ~ " . , .. , , .'-1'" , " ":: ".'" ~ >', .! , . ",: .- " " ", " ' ". . ( . ~ '. " " , " :' .,' \; ~ ,\ ',' , "'.' '. , ': ..... , " " ," " . , " , , " ~e. 21. 1961 ; , " .. "q' ? , " . , , '. ,',., . ';' '. " " r,' , :\:~\.~.,~' ' , ~ . ! -, .' '. " " " , ' " , ,. , ". "'" ,: '1, . ,,' ,. . . , " , " " '~, " ~ :' ' '" :' ~ ~ . ' . ' '~}. . '" " ' " ,,' '.JANijts:' " " .i",. ~ . ",,1 E 't ',! ' ",". . ," . nc. ., , ( ,"', " " "'c:CIC1ty~ Clerk": ' ^ , ,,'.' , "'. . " .;. ,:;. , , " ,. , , " , , " .\ , l' ,-" ~ ~ .' '" ' , .: " ,j '. ^ , y . .. ., -,,, ',' '1 , ' , ',' -, .:' \ /, .' <<", .' /','. , , ~ ' ~. 'i . , " . , , , , " , ~~ , : 'I" I' . : ',:,.., ~ , " ., '~, , ' " , . '~'. ~ , . , . ; .... ',"'. .;' , " ".~ ' . \,., ,", ' "(... ,.;. . :". , " If" f , ;'" ." '.'1 -:;Y .: ,....',. '" . ,., " ,~ - '. ' " , .... " ,t' . - ~: . ~ ..,..- .' ..... : '. I ~ ,. , " .( , . ~', . " , , , t. " , . " ' '., ;, ...', " , ". ' , . ". ~ '.~: " ..'. ", ..' " , . " , :' '. . ~, .;. .~ , o ,; :" ," , , " .... '- . , ~ .. ~ , , '. "-. .., ' ~ ,. ,',' .."" >: . . . "", ': ~. ,"v'olo" , , .' ~ , , , " ~". , l'.' .. " , , ": ' , , . " .'.~ . \ ,,:' .::..." '" ' .. ,~ ~.. . l.- ' . ' '~. '''',~ .. " ,,' , ..' " ; o , " ~~" . ~, . ~; ," '. ., ,P , '. . '.. , . ~ '., , . , '~~.~ ,'': , '\" .. , " ., t " . ., / , :l.. " r \, " , ... -", , ",' " " '<:; ::,~ ~~.~ " , . ,'( ~. .., " :.'." , '" :. , . -, , ,.". , . I ,., , <,tV, ....., ' , ' , " . , , . JAMES' A, NICKLIN ,', ' City, Attorney , :' .." '.; " :..' ~ , " " , . ~ , , ~..l r"; .: '''~:. ":".. " , , ~.i,..., , .. " , " " ,... ~~,..::~ , "r . ~ :: , . " t." ,'t\. <., " " , .' ,. :: ,t". - }, ,,;. J ". , . :' , " , :' ."","" " '.'~: ':=!' '",,:~ ;> ~,:,~~', :.~ , ' , , , , ...... . (, 'i /'1. ", . , . ~ . J" , , , , '~. " . , " , ......- '.,' -.' " '\. . '. '. , . " ,. " , ' ,'/," . ," I , : {;l'J::( U~' A\{{;AJ)lA ., 2883 .... ---'''''''W'VI AND WHEN RECORDED MAIL TO RECORDED IN OFFICIAL RECORDS OF LOS ANGELES COUN'TY, CALIF, 45 ~~ 2 P." JUN 13 1967 RAY E. LEE, County Recorder r~ LA I I Ng".,. City Clerk P.O. Box 60 Arcadia, Calif. ~ Slreet Addre.. CIty" L Sigle SPACE ABOVE THIS LINE FOR RECORDER'S USE TO 426 C Affi~~ ~~~=!?~~!~'N!?lNC!A~iT~!C!A~pant [FREE rA A I COUNTY OF LOS ANGELES }ss STATE OF CALIFORNIA, R. Irving McCallum That Frances A. McCallum to' Certificate of Death, IS the same person as named as one of the parties in that certain .; executed by to R. Irving McCallum and Frances A. McCallum as joint tenants, recorded as Instrument No 2567 , on Februarv 15. 1963 book D-1922 , page 368 , of Official Records of Los Angeles 'County, California, coveTIng the following descrIbed property situated in the , County of Los Angeles Frances A. deed , of legal age, being first duly sworn, deposes and says: , the decedent mentIoned in the attached certified copy of McCallum dated January 8. 1963 , in City of Arcadia , State of CalIfornIa: The southerly 12.00 feet, measured at right angles, of the east 100.0 feet of Lot 146 of Tract No. 2731, in the City of Arcadia, County of Los Angeles, State of California, as per map recorded in Book 33, Page 29 of Maps, in the office of the County Recorder of said County. That the \'alue of all real and personal property owned by said decedent at date of death, includIng the full value of the propel ty above descrIbed, did not then exceed the sum of $ . Dated ,/Y ~"c '-- J? /~? ( ~~.~/....? . '-"'-' SUBSCRIBED AND SWORN TO before me ~ ~ "" "', /) --,{ '~t' C ~'''' "". this / day . .' . ,'. , ::.vL u::. \~~ ..,. .~. (J<.fJ '. SignllUf - y.... "" Itl'. / RANK H. CLOUGH .' . / .... ,,! ,~~ 0........ . ~.. ~ ~.....~ ....- '.___ N " (CT""""'~'.,(,ln.,l;:r;;",[os.Aug. IJ,.JY~- ..... l~,.,..f_ ame ypea or rrlnea, _~ ~ :,"" e.,.'. >e'C.: ~14'-"~":'-:;~~ ~ ~;. :-~ .~~ ~: ,.) ..>...:: .t-?'.... vO .,:- ......,:. .. '.t. - I, J'n1\ ,." This document is being recorded free under Government Code Sec. 6103. (ThiS area for offiCial notanal seal) Title Order No, Escrow or Loan No. CJl'b 2 -, .... -:. ..~ t ~ .. , AFFIDAVIT AFFIDAVIT DEATH OF JOINT TENANT , . DEATH OF JOINT TENANT 'Jt.; :'1 Title Insurance, " and Trust Company Title Insurance and Trust Company , COMPLETE STATEWIDE TITLE SERVICE WITH ONE LOCAL CALL " , , COMPL"ETE STATEWIDE TITLE SERVICE. '. WITH ONE LOCAL CALL ( , ,. ,'-I " , '., . '. '" ~ ",' ' /, STATE OF CALIFORNIA ~~ 03270 r G 30 / --:1 . ) SS. ; C/?UNTY OF LO~ ANGELES ) On/AI' nA ___--Iv If;!'?;? before me, the undersigned, a Notary Public in and for said State, personally appeared Frank Clough,-Known,to me'tocbe:the Special,Representative, and Agent of the municipal Corporation that executed the" within Instyument., known to. me to be the person who executed the within Instrument on behalf of the municipal Corporation therein named, and acknowledged to me that such Corporation executed the within Instrument pur~u"nt",to authorization of the City Council of said municipal Corporation and entered ~pcin~its.-.'" f 1 i ' <<,. -.. o ficia m nutes. ,_"->., , ,", -; .. ' "," WITNESS my hand and official seal. ;: ~ ,~:_ f',',{ " '; :'. ~ ) Signature ~~ J' MELBA B ANDREWS ' My CommIssIon Expires May 23, 1967 ::;., ; ;'<~;~~.\ '....1' : .~. : .. ,"'...,', "., ~ '",v!".. ~ \ '.~ C '"''-. Name (Typed or ',~F~nted).,:. . ,," . . , '/ If"'.!)' ';;. "':..\ ' ~ .:1'1 \.. ., ., '. ,,' O' . '-- TO ....7 C (Individual) ~.~ @'1jO ~ . i STATE OF CAL::RNIA COUNTY OF ~~" 4d'~ / . .r./ / On ~....v" r. /? /'FCL-).efore me Stat; personally appeared ~. .vv... ~ ~ , , ( . . . r . ~ ~ ~ ~ w } 55. the undersign~ a I'j9tary PublIc in and for said /7~ ~,?//"'- , known to me to he the person _ whose name to the wlthm Instrument and acknowledged executed the same WITNESS my hand and 0 "i , ) . Signature .I) subscnbed " "'''''''' .A "(' . that t!" .'. ,'~ \. ~.' .. t>... ", .... . . . .' ,. . "'A : '::._' 10' .>' ,:.......' ,- \ '-?"- '~- ~ 'f .... ~: ~~- < ~. , . :.J FRA H CLOUGH My Commission Expires AU9. J3, 196s Name (Typed or Printed) ... '. ~ : J'-' ,- -.' o (TIIII area tor ofl'lel.1 notarl.l leal) ., ,...~ . ~ Trf1. - \ //~ 7- c?/ ~~ed ~!;-J'~-;fit This agreement is entered into this /;> 14- , 'ic,(" ~, by and between the CITY OF ARCADIA, a Municipal Corporation, hereinafter called day of I ~~ D327DrG 29 I FREEt N , ~,.,.vct{,.., AGREEMENT OF PURCHASE AND SALE .' the "City", and R. IRVING MC CALLUM , hereinafter called the "Owner", as follows: In connection with the proposed widening of Duarte Road \ the City hereby agrees to purchase frOm the Owner, and the Owner hereby agrees to sell to the City for a gross purchase price of $ 2,108.61 that certain prop- erty situated in the City of Arcadia, County of Los Angeles, State of California, described as follows: The southerly 12.00 feet, measured at right angles, of the East 100.00 feet of Lot 146 of Tract No. 2731, in the City of Arcadia, County. of Los Angeles,. State of California, as per map recorded in Book 33,.page 29 of Maps, in the office_of the County~~~order of said County. RECORDED IN OFFICIAL RECORDS OF LO:l ANGElES COUNlY, CALIF. 54 = 9 AM.APR 13 1966 R'AY r.. l.U, ~r "~ ------- .. ,\ . The owner agrees to furnish to the City upon demand a grant deed to said property, and to execute all requests for partial reconveyances from holders of trust deeds and other encumbrances, and to cooperate with the City in obtaining same. Owner warrants that he has title to said property, and whether a partial reconveyance is in face ob- tained or not, owner agrees to hold City harmless for any defect of title, including such payments, expenses and disbursements as the City may be required to make to clear the title thereto, the total of such items to be deducted from the gross price above stated. There shall be no proration of taxes or insurance. The City further agrees that if it accepts the deed to the property hereinabove described, City will install.- curbs, gutters and pavement therein and replace existing sidewalk and concrete drive- ways, such initial installation and replacement to be at City's sole cost and expense. ,I 'i . This agreement and all terms and conditions thereof shall inure to the benefit of and shall be binding upon each party hereto and the heirs, executors, administra- tors, legal representatives, successors and assigns of each party hereto. !R~~--- R. Irving Callum ~ ?J ., Cost of sidewalk and driveways to be subtracted from above amount. Cost of said sidewalk and driveways is $271.00. ~~c. ank H. Clough, Special Representative " I .;~ ~IlD FOa RECORDATION BY i!:ff'r Of' AllCIIDIA UNDER CALIFORNIA ~ CODE SECTION 6103 ~ ( <::) to.- c..D (YJ .0 '-= <=> ~' ", " t_....kr'-. if ,~1l A' I " I \ , I ! ,~ - ;J\ ' ...51 "', i ;r- , I " -~7~' , .-- '. -'f)' . ~ .-/ c.= =- ' / 'j;;. .: , ~-':" '" ~'\ // ~/ R ' I'_,i i'. ". ~a---N ~I c' di ~~II las ~~II :)1 ~ ~: II t' .." # .' ~ ~. "~ ~ ,. ..::.I"~ .,~ c. I, ' ~'1. /'. - ! /:.r--J: ~.~ J. r: I ~- i.' .~- i / i , -~, , - - -/ . I 2$830..:.::;:-, '""'!'lIII ", , \ , . ------~-- '- I i .. ') '," I CIIH'IFIC'ATI"O' !)IAY,I STAn: Of C"'UFOflNI" DE'AJmfEHT 01 ftl:L1C '.ALTH MIDDLE NAIIr i Ie lAlT IlAl:l~- . : lie CALLlilI 8IRTHI"\.ACf ~::..~'_c e DATE OF D1RTH I ;[,...~, Californla Novao:bol' B IlIl 4& . IIlA1DEN MI4E AND BIRTHPLACE or ~nitlt 10 arJl[fI or "MAT CO\MII'I' n CO<W. U(:UMT ~ Sarab McPberlJon -, .Y. .....U.B.A. 13 :.....~~ 1. IW:[OILUTUll'I.O'nIGCOCPAXf~"f';:" - 15- .ffll'.:DUSTRTOAtU::z:; _ ~, r....bor 1 wk'. 1_ 18 Cit Soboo Diet, Scbool . 10 i~'::m~~:~::'......r:.".....;~~~ 17 =-~:=J~~ I lib NAIIE OF PREs T SPOUSE 18e PCL~OO1LAsrOCCUPATIo:JOF'POU$l INiver Married 8"112 lSoCal11C1 Per 'Dnal I "- l~ PL.A"E OF DEATH-fu.IIIor ItO$InAL 191 STRUT AD l.wtpunCQ__~o:lI.O,,:nclCll C1f1-~'o COJ~' -(>. P~iE .~ " 6212 No.; Burton Ave. D=-~ ~a:-~'.\" DEATH l~e 'OR TOWN I" COUNTY lk l.OIGTMOf"fT.n. f 1::' UJlGOIOf"Sf"'. ; {SAN GABRIEL / --.:rl, "17 7 LOS.um !gS CO.........;& \ ""'- 48 LAS1USUAL lO. LASTUSUAlRES'DENCE-$JU.Elf~us,__ 10. .._tITl ",~cmc:cw.w.TlurnI ZIA.NAt:Earll:1~'.-=aTPII~' RESIDENCE f"-....__.l.O(.O,_."...._~.....u_.., COO_U,IJI:fn....._. '...l.l..t>~fer.IlD~ I) B A e Q-- D."- - UVl_' '. ~ .':~.ClTY OR TOWN Zo. COUI'fTY 101: STiTE DI'TU.Q/DIPlCf:JlfOlll',,"-- I ._1 tl- 9, ~. '. , H862-~::, AGNBS .~ DECEDENT P~RSONAL DATA v . ~' '-...- ~ ~- 11&. ADORlSS Of c:f0R::Wn" :=~--- . .,' ::,...--' .: PHYSICIAN'S ! OR CORONER S CERTlF!CA Tl0N~ _........_."V ...__..~..._....... FUNERAL I DIRf~~OR \ LOCAL REGISTRAR: 23 :"~:~= '",._., ~<: 24 OATE 15 HAe[ or cu:nW 011 CltWAiORT 27 NAME OF FUNERAL OIRECTOR ::" ~'::'" N;. - 2e=~_ .. t.<>l:Al. ~ : ~~ - 19U ';c.q.j 30 CAUSE OF OUTH 'AIlTIDUlllWUCAl.e'UlB'/ IIIIlEOU.f(CAliU<I, . ~iffu"-' J ~ttr I I ~ ~ '" c or ~ ~ '" ~ or c z '" ~ '" u a ~ " CAUSE ~ OF DEATH " \ 4 IIrnIIDl jOraT "'" ~r.l r'~ \lllllfNln I.., ..~ a/n"( A'nors'--cllrC"OIIr ~ " @5'....-.-. ......... -..... I ...._. ~"""':':i='W''''' ,-- EC..O:5...,....__ o ~;:::~."n. ..-........ .....,..... -~ D ~:~::..~~~..". [~=~... _l:-:"J-:-..~::'.... o SCItlBL HO~ UiJuRY oc mo ..,...._ ._....__..__.._._...._.. .., ._~.._ , 1 SUICIDE OR HOMICIDE ~ ." , - ~. DoI,' uv I , .., COY TO'tIN ORlC;;;noN----~~-.--~;~;:""-- i , I .------..--- Cot!7fi Il!Ml!)El t u . J5c PI. ~CE OF INJURY ;~~.": ;~-::.:..._ -. .T,,~n D7.H'~ .,,"U'_'." , / rUed'MAY 29 1964 I RAt l!~ y;, ,/ ,/ /. t .,.~.....- - :H . . . / S:. ..' ,', ~ . ,~ " I "h,: " ~ I(t ;;1' . /\; ~ ::'.',OFILM l:, ~ :,,:' ':;UCTS / ~' "ILn .r;' " ~ I i: "!,,~VT I ,0 ~l ~,.., .J. ',. fELEC','''O,CO'''''UC-IIV' . ). ,'~ , _.. 1\, ,;; . L, ~.( [. vu. 1 e0 :' WITH L1ye: CIRCJITS '- ~', , .. . , , ~ ~,~:; , r Ki: . /r\ 3M .... ~. '" "0"11 M -... J'r.ODUCTS ,J'" ~ ." 'CAt iTIOl'j , . ,r.~pm is . cECTflO-COr~DUCTIVt. aWm CONli.GT WITH LIVE CIRCUITS 'r , ~_._., . . , . ~ I' ." i.,. ':',:' r . .... - , , , .. . .' ...... C AUT! 0 1'-; TEIS PAPER IS t:LECTRO,CO;'~DUCT,Vt, i'.VOID COi'JACT ';.'ITH LIVE CIRCUITS ._~,.rt . 'q , -j i 1 : I , 1 , I i -!, J ~ ..~J