DEATH CERTIFICATE

Green Stacy

Cert: #15671
Name: Green Stacy
Male, White, Single
Age: 30
Occupation: Coal Miner
Place of Death: Bulan, Perry Co., Ky
Birth Date: Blank
Place of Birth: Perry Co.
Spouse: None
Father: Joe Stacy
Mother: Nancy Jones
Informant: John Stacy
Death Date: 11 May 1940
Cause of Death: Gunshot wound in head - Homicide
Signed: D.D. Turner, M.D., Hazard, Ky
Burial Place: Ary, Perry Co., Ky
Undertaker: Ray Engle, Hazard, Ky
File Date: 17 June 1940
Transcribed by John F. "Freddie" Wilson 12 May 2005

Green Berry Stacy s/o Joseph Stacy & Nancy Jane Jones