I. Andrew Jackson Standard Certificate of Death State of Oklahoma Submitted by: Lesa Thompson wolfpainter2@aol.com --------------------------------------------------------------------- USGENWEB ARCHIVES NOTICE: These electronic pages may NOT be reproduced in any format for profit or presentation by any other organization or persons. Persons or organizations desiring to use this material, must obtain the written consent of the contributor, or the legal representative of the submitter, and contact the listed USGenWeb archivist with proof of this consent. The submitter has given permission to the USGenWeb Archives to store the file permanently for free access. --------------------------------------------------------------------- 1. Place of Death: (a) County-- Mayes (b) City or town-- Mazie Rural (c) Name of Hospital or institution: (d) Length of stay: 2. Usual Residence of Deceased: (a) State- Oklahoma (b) County- Mayes (c) City or Town- Mazie Rural (d) Street No.- 2 West 1 mi So. (e) Citizen of foreign country? No 3. Full Name: I. Andrew Jackson 4. Sex: Male 5. Color: White 6. (a) single, married, widowed, divorce: Widowed (b) Name of wife: Lula Bell (Cawvey) Jackson 7. Birth of deceased: Oct. 2, 1877 8. Age: 68 9. Birthplace: Missouri 10. Usual occupation: Farmer 11. Industry or business: Farm 12. Father: Franklin Peirce Jackson 13. Birthplace of father: Missouri 14. Maiden Name of Mother: Nancy Elizabeth Carter 15. Birthplace of Mother: Missouri 16. (a) informant's own signature: (b) Address: RFD Mazie, Okla. 17 (a) Burial (b) Date thereof: April 21, 1945 (c) Place of Burial: Hulbert, Okla. M. Booth was embalmer 18. (a) Signature of funeral director: Her ?? Funeral Home ( b) Address: Wagoner, Okla. 19 (a) Date recieved local registrar: 6-1-1945 20. Date of death: April 19, 1945- hour 12 minute 20 a.m. 21. immediate cause of death: Congestion Heart Failure Isaac Andrew Jackson is burried in IOOF Cemetery. He is my Great grandfather on my fathers side. Lesa Thompson