HomeMy WebLinkAbout05-06-15 IN RE : IN THE COURT OF C(>MMON PLEAS
: OF CUMBERLAN I� COUNTY,
: PENNSYLVANIA
ESTATE OF YOSHIKO S. BLEW, : ORPHANS' COUR1' l)IVISION
Deceased :
: FILE NO. „� � `I:��',� �u:;�'J�
Affidavit Concernin� Death of Gary W. Blew,
Son of Yoshiko Sanqei Blew
I, Susan A. Brink, being duly sworn according to law, hereby depose and state that I am
56 years of age; I am one of only two (2) biological children of Geor�e W. Blew, Jr. and
Yoshiko Sanpei Blew; the other biological child (my brother) was Garti� W. Blew; Gary W. Blew
died on January 8, 2013 of cancer; a true and correct copy of his dLath certificate is attached
hereto, marked Exhibit"1" and incorporated by reference; and I h��ive r�o other siblings, half or
whole blood, living or deceased.
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Sus�ua A. Brink
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Sworn to and subscribed � � :� r:> �
before me this 6t" day of �' �'_ �-, � ."�{ �;
May, 2015 '' � � '. '`;
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''�LILA RESSL�R,Notary PubliC'� r-� �� �
' Swatara Twp.,�auphin County.` C� �
My Commissiorw Exp6res September 29,2018 �
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� DEMARCO FUNERAL HOME (Kee1e Chapel) Inc.
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�1� � 3725 Keele Street,Toronto, Ontario M3J 1N4
Dell�arco Telephone: (416)636-'7027 Facsimile: (416) 636-5337
FUNERALHOME __
FUNERAL DIRECTOR'S
PROOF OF DEATH CERTIFICATE
NAME OF DECEASED: GARY WILLIAM BLEW
RESIDENCE: 89 Ridgeway Crescent .
Maple, Ontario L�6A 2R5.
AGE OF DECEASED: 56 Years
DATE OF BIR.TH: January 26, 1956
PLACE OF BIRTH: U.S.A.
DATE OF DEATH: January 8,2013
PLACE OF DEATH: York Central Hospital
. Richmond Hill, Ontario
INFORMANT: Kevin Macna.b Friend
2777 Langstaff Road
Concord, Ontario L4K 4M5
TELEPHONE: (416)457-0802
PLACE OF FtINERAL: DeMarco Funeral Home
Toronto,Ontario
CREMATION: Brampton Crematorium
Brampton, Ontazio
We certify that the above information in this document is true and cozrect according to our files.
Date on the lOth day of January, 2013.
DEMARCO FUNER.AL HOME(Keele Ctiapel)Inc.
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Funeral DirectQ.r
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