Date:  30 May 1956
Cert: #56-12609
Place of Death: County: Knott      City or Town:  Leburn - Rural
Length of stay (in this place): (blank)
Full Name of Hospital or Institution:  (blank)
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Leburn              Residence on a Farm?:  Yes
Street Address: (blank)     Residence inside City Limits?: No
Full Name:   Joe STACY
Date of Death: 30 May 1956 
Sex, Color or Race, Marital Status:  Male, White, Married
Date of Birth:  16 September 1900
Age:  55 years
Usual Occupation:  Farmer
Kind of Industry or business: (blank)
Birthplace:  Breathitt Co., Ky. 
Father's Name:  Shade STACY 
Mother's Maiden Name:  Easter LITTLE
Was deceased ever in armed forces:  No
Social Security No.: (blank)
Informant:  Mrs. Joe STACY 
Disease or condition directly leading to death:  Heart Failure
Interval between onset and death:  (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (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:  02 June 1956  
Address:  Hindman, Ky. 
Signature:  John Everage, Coroner, Knott Co. 
Burial, Cremation or Removal: Burial
Date:  02 June 1956
Name of Cemetery or Crematory:   Dyer Cem.
Location:  Leburn, Ky. 
Date received by local registrar:   04 June 1956
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky. 
Transcribed by Debbie Tamborski, 26 March 2012