DEATH CERTIFICATE

CLARENCE STACY

Date  14 February 1924
Cert: #  04334 
Name:  Clarence STACY 
Place of Death: Voting Pct. #2, Knott Co., KY
Male, White
Birth Date:  (blank) 
Age:  15 years
Occupation:  (blank) 
Place of Birth:  Ky.
Name of Father:  Silvester STACY 
Birthplace Father:  Ky. 
Maiden Name of Mother:  Rinda GAYHART
Birthplace Mother:  Ky. 
Informant:  Rinda GAYHART, Pine Top, Ky.
Death Date:  14 February 1924 
Cause of Death:  (blank) 
Signed:  (blank)
Burial Place:  Sim Watts Cem. 
Date of Burial:  14 February 1924 
Undertaker:  (blank) 
File Date:  16 March 1924 
Transcribed by Debbie Tamborski, 20 February 2009