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Disposition PermitDISPOSITION PERMIT DECEDENT'S NAME SHEILA JEANNE KULFF-BRUNSBERG DECEDENT'S ALIAS SHEILA J. BRUNSBERG SEX FEMALE DATE OF BIRTH / AGE APRIL 07, 1958 / 49 YEARS DATE OF DEATH AUGUST 08, 2007 PLACE OF DEATH 7150 UTICA LANE CHANHASSEN, MINNESOTA CARVER FUNERAL DIRECTOR M3058 WALLY GELECINSKYJ FUNERAL HOME 0914 HUBER FUNERAL HOME & CREMATION SERVICE 16394 GLORY LANE EDEN PRAIRIE, MINNESOTA 55344 PLACE OF DISPOSITION CHANHASSEN PIONEER CEMETERY CHANHASSEN, MINNESOTA According to Minnesota Statutes, section 149A.93, subdivision 3, section 144.221, and Minnesota Rules, part 4601.1500, the fact of death has been filed with the Office of the State Registrar. Steve Elkins State Registrar Authorized Disposition Occurred on: Signature of Crematory or Cemetery Official:, - -i U oL, -j- (type (type or print name of crematory or cemetery official) l3, ,)00 -7