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Date: 25 July 1936 (transcribed as
written)
Cert: #56-27720
Place of Death: County: Knott
City or Town: Lackey
Length of stay (in this place): (blank)
Full Name of Hospital or Institution: Stumbo Hospital
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Raven
Street Address: (blank)
Full Name: Elisha H. OWENS
Date of Death: July 15, 1936 (transcribed as
written)
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: (blank)
Age: 42 ? (transcribed as written) years
Usual Occupation: (blank)
Kind of Industry or business: (blank)
Birthplace: (blank)
Father's Name: (blank)
Mother's Maiden Name: (blank)
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: (blank)
Disease or condition directly leading to death: Gun
shot wound
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
Accident, suicide, or homicide: (blank)
Describe how injury occurred: (blank)
Time of injury: (blank)
Injury occurred at work: (blank)
Place of injury: (blank)
City, Town or Location, County, State: (blank)
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at (blank), from the causes and on the
date stated above.
Date signed: Facts supported by affidavit of
Juanita Ratliff, Elizabeth L. Owens, Chas M. Owens, Miles M.
Owens
Address: (blank)
Signature: (blank)
Burial, Cremation or Removal: (blank)
Date: (blank)
Name of Cemetery or Crematory: (blank)
Location: (blank)
Date received by local registrar: 23 May 1957
Registrar's Signature: J. (illegible) State Registrar
Funeral director & address: (blank)
Transcribed by Debbie Tamborski, 26 April 2012
AFFIDAVIT IN SUPPORT OF DEATH OF
ELISHA OWENS
STATE OF OHIO
COUNTY OF MONTGOMERY
ELIZABETH L. OWENS, being
first duly sworn deposes and says:
That she is a resident of
the State of Ohio, County of Montgomery, and that her
present address is 2601 Ottello Avenue, Dayton 4, Ohio:
that on or about the 25th day of July, 1936, affiant was
present at the Stumbo Memorial Hospital, at the Town of
Lackey, County of Knott, State of Kentucky, and that at said
time and place Elisha Owens, husband of Frances R. Owens,
died in my presence as a result of gunshot wounds inflicted
by one John D. Huff who was later convicted of murder and
sentenced to state prison in Kentucky.
Further affiant sayeth not.
ELIZABETH L. OWENS
Subscribed and sworn to before
me this 4 day of Mary, 1957.
Montgomery Ohio
Notary Public in and for said
County and State
VARINIA BROWN, Notary Public
in and for Montgomery County,
Ohio
My Commission Expires Nov.22,
1958
AFFIDAVIT IN SUPPORT OF DEATH
OF ELISHA OWENS
STATE OF OHIO
COUNTY OF MONTGOMERY
CHARLES M. OWENS, being
first duly sworn deposes and says:
That he is a resident of the
State of Michigan, City of Detroit, and that his residence
is 28595 Sibley Road, Romulus, Michigan; and that he is
the son of Elisha Owens and Frances R. Owens, and that he
was born on the 9th day of May, 1920, and that affiant was
present at the Stumbo Memorial Hospital, at Lackey,
Kentucky, on the 25th day of July, 1936, the date of death
of the said Elisha Owens, and that affiant knows of his
own knowledge that said Elisha Owens died as a result of
gunshot wounds inflicted by John D. Huff who was later
convicted of murder and sentenced to state prison in
Kentucky.
Further, affiant sayeth
nothing.
CHARLES M. OWENS
Subscribed and sworn to before
me this 4 day of May, 1957.
Montgomery Ohio
Notary Public in and for said
County and State
VARINIA BROWN, Notary Public
in and for Montgomery County, Ohio
My Commission Expires Nov.22, 1958
AFFIDAVIT IN SUPPORT OF DEATH OF ELISHA OWENS
STATE OF OHIO
COUNTY OF MONTGOMERY
MILES M. OWENS, being first duly sworn deposes and
says:
That he is a resident of the State of Ohio, County
of Montgomery, and this his present address is 2601
Ottello Avenue, Dayton 4, Ohio; that on or about the
25th day of July 1936, affiant was present at the Stumbo
Memorial Hospital, at the Town of Lackey, County of
Knott, State of Kentucky, and that at said time and
place Elisha Owens, husband of Frances R. Owens, died as
a result of gunshot wounds inflicted by one John D. Huff
who was later convicted of murder and sentenced to state
prison in Kentucky.
Further affiant sayeth not.
MILES M. OWENS
Subscribed and sworn to before
me this 4 day of Mary, 1957.
Montgomery Ohio
Notary Public in and for said
County and State
VARINIA BROWN, Notary Public
in and for Montgomery County, Ohio
My Commission Expires Nov.22, 1958
May 4, 1957
Bureau of Vital Statistics
Department of Health
Louisville, Kentucky
Gentlemen:
I enclosed herewith two original Affidavits in support
of the death of Elisha H. Owens, who died on July 25,
1936 at the Lackey Memorial Hospital, Lackey,
Kentucky. It seems from previous inquiries that no
death certificate was ever filed. Pursuant to prior
correspondence, it is my belief that you will provide
us with a death certificate upon the basis of the
enclosed affidavits.
If you can issue us a birth certificate a photostatic
copy of the same by return mail would be appreciated.
A return envelope is enclosed for your convenience.
If you cannot issue a death certificate, please advise
what further additional information is necessary.
$1.00 check is enclosed, to cover your costs. Yours
very truly,
Juanita Ratliff
4401 Richland Drive
Dayton, Ohio
Enclosures (2)
Transcribed by Debbie Tamborski, 26 April 2012
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