81443-180360-0228

State File Number: 93

County: Beaver

Child's First Name:

Child's Middle Name 1:

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname:

Child's Suffix:

Sex: Male

Month of Birth (Number): June

Day of Birth: 7

Year of Birth: 1912

Father's First Name: James

Father's Middle Name 1: W

Father's Middle Name 2:

Father's Surname: Eyre

Father's Title or Suffix:

Mother's First Name: Rosella

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Murdock

Is there an Amendment?: Yes