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:�� ' ' C[F2TIFICATE OF DEF�TH DISTRKT/tl0
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MUMe[q___ .. _�. ._ _ STATE Of GLIi'ORNIA-DEPARTMENT Oi VUBUC HEALTN �FxnrKU[ NuMB[a_.-O_ SJ_..__
, IA. NAME OF DfCEA5E6-lIHSi NAMC�b. HAME ' Ic USTNAME `/ 24 DATE OF DEATM-MOxiH. o�i. run 1 2�. NOUH
P.zra i Gannon i Pearce December 2 1964 � 6:50 A■.
� 3. SE% l. COIOR OR RACE 5. BIRTNPLALE �o�,'�;,o..o.uc� 6. DATE Of BIftTH 7. AGE�m••�•�•e•�� v uxoc��iu+ vuxor� x� iwurs
Male White Iowa Au ust 2 1878 86 YEIRS
DECEDENT 8. NAME AND BIPTHPIACf OF FATHER 9. NAIDEN NAME AND BIHTMPLACE Of MOTHER I0. CITIZFN Oi wx�T COVnTnY II. SoCil�l SECURIn NUMB[R
PERSONAL
Dnia Fred Pearce - no record Ella G nno - United States None
12. LAST OCCUPATION �3. Nrxnrcar��w� ��� M�ME Of LAST EMVLOYIMG COMY�NY OP fINM p. I5. KIND Of INDUSTflY OR BUSINE55
19�. PIAC! Di OE�1N�1etE Oi HOSVIT�L _ 19�. STPEET I1D�RE55-�uv[ n�cira� �u��t �oo�asae �ncenon. eo xo* us[ r. o. wa xun[q�
PLACE ���
OF San Luis 0 is o General Hos it 1 p �� ��
DEATH ��� ��TT OR TOWN 190. COUNTT �9[ IENGTM Of STAY IN 19r. LEnGix Oi R�T w
COUNTY Oi DFATM G4LOPNIA
n Luis O' o San Luis Obis o rc�ns 34 runs
LAST USUAL 20�. LAST USUAL RESIDENCE-STREET ADDaESS �c�.n..e� 20a n��HOC nn n wrs�o[ cm wero�ei[ unrs 21e. NAME OF INFORMANT ur mHU ihu sraus[�
RESIDENCE u.w..owmw.x..w,.ww,w..a.w.....in� cwroiur[u�rts aa.0
m�a�orooecus�e 260 South Halc 0[1 • Road � ° ` °FtH ,�°•r°• ❑' Mrs. T�anita
uv�-+� N wmrvna 20c. G7Y OR TOwN 200. COUNTT 20c STATE 21a ADORE55 OF INFORMA�
am �oinari mw[ �
���� Arro o Grande an Luis Obis o alifornia Ventura Cal'
22w PXYSICIAN: �.��o.ea.n.r»�.eom.oeeennm�rme.w..o.+a�w 22e. PHT CIAN OR NER- RE
PHYSICIAN'S + � `�+� o .e*.... ..��o«....o o�«�r _ / .l�r
OR CORONER'S � �P �Lv G /-/ � �-
22�.CORONER:'�,, e.ri..o.ucaa... 220. �RE55 .� �
CERTIFICATION �..�...<':��:;�.°o`.`�.".e:.�.o::.,';°„"::�„m "
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FUNERAI
23..n.a,,.:,',°.�"'°""" �2t. DATE 25. NAME Of CEMEfERY ON C EM TORY 26. EMBAL R-SlcNeiunEa
DIRECTOR gurial 12-5-64 Arro o Grande Cemeter �
AND w,a.�c�n�o^w �ioiar�.
�p�q� 27. NAME OF FUNERAL OIRECTOR uu�,`c:i 28 � no.. «,�...a 29.. OCAL REGIS�ic rVRE
REGI5TRAR Eail W. WOOd � � � �
30. CAUSE OF DEATM ♦ aru qy� w,p uus[ r�� � roR ���. r. uo �o
►�m � oun� was uuseo e�: i G ��i •
�IEp11lE GUSE ���
• � � � ¢'
CAUSE ea.� n�o.a n1 �P LG CI-�L//LC� +K�h.!/ZL9
� OF ....:�..,o. � ouc m �n
; oeani �: � ::�",: �` Q _ � /� •
� ��.�.�.e �.fi�C'1-ccd �'vice�s4?-!/✓-- .
WEroai
� ►YR L OiME115�GNiMiVIT COnDiTq TO OFATX NOT PELITEO TO TME TENMixAt OISEAS CO�IIODN GVEN IN YMff ���
� L'w+-rlet-ve-o e.�Pr�lv c4.� o-c.�-Cc� rttte� s�Ec'hc�.c o
C OPERATION 31. OPERATION-CMECK o�E: � 32. DATE OF OPERATION 33. AqFOPSt--CNECIt oNE:
�.nw.a«wns- �unm.a�'o.�sss�.
j AND AUTOPSY ° . p '�` a,•° ❑��: ;:'�:'.o.�.r..0 ❑ �..'::�.' ❑ iwa� sm..i.�.'�".:en>..�
•.uraw '��� c.�..:wen..
j 34e. SPECIFY ACCIDENL�SUICIDE HOMICIDE 3b. DESCRIBE NOW INJURY OCCURRED �•......•...+�...ae..+o..,... �...�.....�
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E 35A.71ME wwt wnrx Nr rw�
INJURY oF mJ1�R1' . .. � .. � . . � .. . � - .. . .
INFORMATION � � . � �, �
35�. IIUURY OCCURRED 35c. PUICE OF WJURt � i ����� a � K � ry � 350. CITY. TOWN. OR IIX�TION
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BEfWEEN�"�
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I his is to certrfY. That this is a
Ar �t �py of the record on file
and that the same has been car�
SAN L�L H D E RTMENT
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RECORDINt'a RE�UESTED BY
AND WHEN RECORDED MAIL TO
r+ame City of Arroyo Grande
s � » � 214 East Branch St.
nee,�., Arroyo Grnnde, Calif,
���, b �
Stale
� TO 4I6 C
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Q�aam No.:_--: �� --_�
�... � 11.4.i.
AT-_'c�---..MIN. PA5Y_�-.e3..PM.
VOL-/�_33.----0/R. P.._...1GSo.1.. .
SAN LUfS OSISFO COUWTY, CAL.
JAN 15 1g65 -
� C:.,�Q�'r�2.e�
By.�G ��.."/!>. _Rd:Fc:�^a�
- - - ° -----°- Deputy
Fee $-2=-8-Q--�ndexed
VOLlefe�c3 PAGED 1'l
SPACE ABOVE Teyasarr�c�fi'ECORDER'S USE
Affidavit—Death of Joint Tenant
TNIS FORM FURNIBHED BY TITLE INBURANCE AND TRUBT COMPANV
STATE OF CALIFORNIA,
ss.
CouNrv oF San Luis Obispo
Geztrude PearCe , of legal age, being first duly sworn, deposes and says:
That E. G. Penrce , the decedent mentioned in the attached cer[ified copy of
Certificate of Death, is the same person as E, G. Pearce
named as one of the parties in that certain deed dated Novembex 19 , 1941
executed by � Champness and Catherine Champneas husband and wi£e
� E. G. Pearce and Gertrude Pearce husband and wife
as joint [enants, recorded as Instrument No 9337 o � Novembet' 27� 1941 ��
book 310 , page 297 , of Official Records of San Luis Obispo
County, California, covering the following described property situated in the City of Azroyo Grande
, County of San Luis Obispo , Sta[e of California:
Lots 1, 2, 3 and 4 of Apsey's Addition to the Chautnuqua Assembly
Grounds, in the City of Arroyo Grande, County of San Luis Obispo,
State of California, according to map £iled for record June 1, 1897
in Book B Page 5 0£ Maps, in the of£ice of the County Recorder of
said County.
That the value of all real and personal property owned by said decedent at date of death, including the full value of
the property above described, did not then exceed the sum of $ .
necea January 6��,g6F
SUBSCRIBED AND SWORN TO before me
�hss�—aa ot January, 1965
Signatu��,'�T�7'l�
SA.SY'l� D MCNP.SZ
Name (Typed or Prin[ed)
�
s� t
t � r.
Title Order No. Escrow or�
official notarial seap