Extract of the register death certificate of the borough of Passy near Paris for the year 1840.
From the 28 August 1840, at noon. Death certificate of Anne Mac Carthy, widow of Lee, unemployed, deceased at her temporary home at Passy, rue de la Pompe, number 13a, yesterday at 5 pm, native of Virginia, United States of America, 40 years old, lived in Virginia, her deceased husband’s first names, her father’s first names and her mother’s first names and surname could not have been indicated on the first registration of death. Louis Gerard, locksmith, 27 years old, living at Passy, rue de la Pompe, number 13a, neighbour and of Auguste Boulabert, employee, 42 years old, living at Paris, rue Monsieur Marc Feydeau, number 18, friend. Certified by us, Louis Simeon Gaspard, deputy mayor of Passy, as registrar, after making sure of the decease, the reading done, the persons who declare signed with me, deputy mayor delegate.
Signed: Louis Gerard, Boulabert et Gaspard deputy mayor.
Considered as copy true to, issued by us, deputy mayor. At Passy, the 31st August 1840. The deputy mayor
Source: The Archives of the Robert E. Lee Memorial Foundation, Papers of the Lee Family, Box 3, M2009.196, Jessie Ball duPont Library, Stratford Hall
Transcribed by Colin Woodward, 2015 November 20
 Certificate is originally in French. Translator is unknown.