81443-180374-0303

State File Number: 3072

County: Salt Lake

Child's First Name: Ralph

Child's Middle Name 1: Walter

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Cushing

Child's Suffix:

Sex: Male

Month of Birth (Number): 11

Day of Birth: 3

Year of Birth: 1912

Father's First Name: William

Father's Middle Name 1: O

Father's Middle Name 2:

Father's Surname: Cushing

Father's Title or Suffix:

Mother's First Name: Isabella

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Morrison

Is there an Amendment?: Yes