Details from the death certificate of Annalee Skarin

CERTIFICATE OF DEATH

No. 3-88-52-000029       BOOK 7     PAGE 420
Tehama County Register, Red Bluff
STATE OF CALIFORNIA

DECEDENT PERSONAL DATA
1a NAME OF DECEDENT - FIRST ANNALEE aka NANSELA
1b.....................................MIDDLE nmn
1c.....................................LAST MATHEWS aka SKARIN
2a DATE OF DEATH - MONTH, DAY, YEAR January 17, 1988
2b TIME 09:50
3 SEX Female
4 RACE/ETHNICITY White
5 - --
6 DATE OF BIRTH July 7, 1899
7 AGE 88 YEARS
8 BIRTHPLACE OF DECEDENT (STATE OR FOREIGN COUNTRY) Idaho
9 NAME AND BIRTHPLACE OF FATHER Frederick John Kohlepp - Massachusetts
10 NAME AND BIRTHPLACE OF MOTHER Mary Ella Hickman - Utah
11a CITIZEN OF WHAT COUNTRY USA
12b IF DECEASED WAS EVER IN MILITARY GIVE DETAILS OF SERVICE n/a
12 SOCIAL SECURITY NUMBER 547-56-6665 **SEE NOTE AT BOTTOM OF PAGE**
13 MARITAL STATUS Widowed
14 NAME OF SURVIVING SPOUSE, IF WIFE ENTER BIRTH NAMES --
15 PRIMARY OCCUPATION Authoress
16 NUMBER OF YEARS THIS OCCUPATION Adult Life
17 EMPLOYER, IF SELF-EMPLOYED AS STATED Devoors Publishers (DeVorss)
18 KIND OF INDUSTRY OR BUSINESS Writing

USUAL RESIDENCE
19a USUAL RESIDENCE - STREET ADDRESS (STREET AND NUMBER OF LOCATION) 70 Gilmore Road
19b --
19c CITY OR TOWN Red Bluff
19d COUNTY Tehama
19e STATE California

PLACE OF DEATH
20 NAME AND ADDRESS OF INFORMANT - RELATIONSHIP Maggie Biswell (Friend) 1246 Yolo St. Corning, Calif. 96021
21a PLACE OF DEATH Cedars Convalescent Hospital
21b COUNTY Tehama
21c STREET ADDRESS (STREET AND NUMBER OF LOCATION) 555 Luther Road
21d CITY OR TOWN Red Bluff

CAUSE OF DEATH
22 DEATH WAS CAUSED BY     (ENTER ONLY ONE CAUSE PER LINE FOR A. B. AND C.)
(A) Respiratory Failure APPROXIMATE INTERVAL BETWEEN ONSET AND DEATH 1 day
(B) Pulmonary Edema ................"................."..................."................."............... 1 day
(C) Arteriosclerotic Heart Disease ..............."..................".............."............"......... 3 years
23 OTHER SIGNIFICANT CONDITIONS - CONTRIBUTION TO DEATH BUT NOT RELATED TO CAUSE GIVEN
Chronic Obstructive Pulmonary Disease
24 WAS DEATH REPORTED TO CORONER? No
25 WAS BIOPSY PERFORMED? No
26 WAS AUTOPSY PERFORMED? No
27 WAS OPERATION PERFORMED FOR ANY CONDITION IN ITEMS 22 OR 23? TYPE OF OPERATION, DATE No

PHYSICIAN'S CERTIFICATION
28a I CERTIFY THAT DEATH OCCURRED AT THE HOUR, DATE AND PLACE STATED FROM THE CAUSES STATED
I ATTENDED DECEDENT SINCE(ENTER AND DATE) 7-16-85
I LAST SAW DECEDENT ALIVE (ENTER AND DATE) 1-1-88
28b PHYSICIAN -(signed) Harve W. Jourdan M.D.
28c DATE SIGNED 1-19-88
28d LICENSE NUMBER A09308
28e TYPE PHYSICIANS NAME AND ADDRESS Harve W. Jourdan M.D. Sis Mary Columba Dr. Red Bluff Calif.

(INJURY INFORMATION CORONER'S USE ONLY 29-35 blank)

36 DEPOSITION Burial
37 DATE - MONTH, DAY, YEAR 1/20/88
38 NAME AND ADDRESS OF CEMETERY OR CREMATORY Sunset Hill Cemetery Corning Ca.
39 EMBALMING LICENSE NUMBER Not Embalmed
40a NAME OF FUNERAL DIRECTOR OR PERSON ACTING AS SUCH Hall Brothers Corning Mortuary
40b LICENSE NO F-409
41 LOCAL REGISTRAR R. A. WICKENHEISER, MD
42 DATE ACCEPTED BY LOCAL REGISTRAR 1-19-88


**Regarding the social security number given on Annalee's death certificate:
Further research indicates that this number was not Annalee's but that of "John Mathews" - one of Reason Skarin's aliases. The social security number for "Nan Mathews" (Annalee), issued in 1957, is 547-56-6586. Whether Annalee and Reason had numbers for their true identities is not known.

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