Date 24 February 1940
Cert: 12870
Place of Death: County: Knott City or Town: Ivan, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Ivan
Full Name: Howard AMBURGEY
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Aggie Jane HALL
Age of husband or wife if alive: 55 years
Birth date of deceased: 24 May 1870
Age: 70 years, 08 months
Birthplace: Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Chas. AMBURGEY
Father Birthplace: N.C.
Mother Maiden Name: Annie DEAN
Mother Birthplace: N.C.
Informant/Address: C. F. AMBURGEY, Ivan
Burial Place: Amburgey
Date: 25 February 1940
Signature of funeral director/Address: Henry Blair, Pinetop
Date received by local registrar: 20 May 1940
Registrar's Signature: Macie Miller
Date of Death: 24 February 1940
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at (blank)
Immediate cause of death: Heart Attack
Duration: (blank)
Due to: Senility
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. W. Duke, Hindman
Date signed: 21 May 1940
Transcribed by Debbie Tamborski, 16 August 2010