81443-180374-0313

State File Number: 3075a

County: Salt Lake

Child's First Name: Volney

Child's Middle Name 1: Stamps

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Anderson

Child's Suffix:

Sex: Choose Sex

Month of Birth (Number): 11

Day of Birth: 2

Year of Birth: 1912

Father's First Name:

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname:

Father's Title or Suffix:

Mother's First Name: G

Mother's Middle Name 1: P

Mother's Middle Name 2:

Mother's Maiden Name: Anderson

Is there an Amendment?: Yes