Date:   18 April 1941
Cert:   15464 
Place of Death: County: Knott     City or Town: Anco
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:  Anco
Full Name:  Blaine WHITAKER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of:  Vernia WHITAKER
Age of husband or wife if alive:  19 years
Birth date of deceased:  20 March 1921
Age: 20 years, 01 months
Birthplace:  Texas
Occupation:  Miner
Industry or business: (blank)
Father Name:  George W. WHITAKER
Father Birthplace:  Letcher Co., Ky.
Mother Maiden Name:  Rose HENSON
Mother Birthplace:  Clay Co., Ky.
Informant:  George WHITAKER, Anco
Burial Place:  Lotts Creek Cemetery
Date:  20 April 1941
Signature of funeral director: G. W. Nickeleson, Hazard, Ky.
Date received by local registrar:  23 June 1941
Registrar's Signature:  Macie Miller
Date of Death:  18 April 1941
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 to death
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: homicide
Date of occurrence: 18 April 1941
Where did injury occur: In store house beside road
While at work: no
Means of injury:  4 gun shots in back
Signature & Address: J. W. Duke, M.D.
Date signed:  (blank)
Transcribed by Debbie Tamborski, 15 October 2010