Nr. 3.
Börzow, the 17th of November 1910
Before the undersigned civil registration officer appeared today, known personally,
the coachman Ludwig Drews, resident in Bernstorf
and announced that the Vogt (bailiff) Johann Joachim Heinrich Lepin
65 years old, lutherische Religion
resident in Bernstorf, born in Grevenstein near Roggensd(t)orf
husband of Katharina Lepin nee Japp, resident in Bernstorf
son of the deceased Vogt (bailiff) Wilhelm Lepin and his deceased wife (name not known)
last resident in Grevenstein
died in Bernstorf on the 17 November 1910 at 7:30 am
The reporting person was a witness
Read, approved and signed
Ludwig Drews
The civil registration officer
W. Neuß