I 8 I 9

Husband's Full Name

FAMILY GROUP NO.

Day

Month

ft1cu-

Z1-

Year

W (.t (t ttfl1

City, Town or Place

County

or Province,

~te

etc.

or Country

Add. Info. on Husband

It!/ B(OLLIIl-~.

Death Burial Places

of Residence

Church Affiliation

Occupation

Military Rec.

Other wives. if any_ No. (1) 12} etc Make separate sheet lor each man

His Father

iJ

V1

k!. tJ () uJ

h

Mother's Maiden Name ...5cL11!'

t£...

Wife's Full Maiden Name Wife's Data

Day

Month

Year

Birth Chr'nd Death

-

JI? 4-.---

l3lou,.,+ &_"I

/ ,ps-r

g

I

Z~hke: :~;:r~~~~~~:tr~rNeO~d~) ~~f~~C#

12 le'Ua.-rd LI ~~~~~~~\;~r~:~ u.. CJn o~ d a.... IFI

Day

b,~~~)

Sex

Full Name of Spouse

.MJ

Month

Year

County or Province, etc.

:z:n

Marr.

,4{~~

Death

c.~SuS. /:;~

~I

Birth Marr.

Death Burial Birth Marr.

Death Burial Birth Marr.

""

Death Burial Birth Marr.

Full Name of Spouse

Death Burial

6

Birth Marr.

Full Name of Spouse

Death Burial

7

Birth Marr.

Full Name of Spouse

Death Burial

I

Birth

8 Full Name of Spouse

Marr.

Death Burial

I

Birth

9 Full Name of Spouse

Marr.

Death Burial

Birth Marr.

Full Name of Spouse

Death Burial

• For additional children use Everton Publishers' Children Continuation Sheet. Form A11 i ."~

RI.u.1- ~.

Birth

It40

).10+t"

~lA.-