Date:  02 September 1940
Cert:  21955
Place of Death: County: Knott   City or Town: Yellow Mountain
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:  Yellow Mountain
Full Name:  Floyd WALLEN
If Veteran Name War: (blank)
Social Security No.: 404-10-3499
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of:  Lida CONLEY
Age of husband or wife if alive:  43 years
Birth date of deceased:  08 June 1898
Age: 42 years
Birthplace:  Knott Co.
Occupation:  Farming
Industry or business:  Merchant
Father Name:  Jimmie WALLEN
Father Birthplace:  Floyd Co.
Mother Maiden Name:  Rilda CONLEY
Mother Birthplace:  Knott Co.
Informant:  Lida CONLEY, Yellow Mt.
Burial Place:  Yellow Mt.
Date:  03 September 1940
Signature of funeral director:  (blank)
Date received by local registrar: 06 September 1940
Registrar's Signature:  Macie Miller
Date of Death:  02 September 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:  Shot & killed
Duration: (blank)
Due to: (blank)
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, M.D., Hindman, Ky.
Date signed:  06 September 1940
Transcribed by Debbie Tamborski, 07 October 2010