81443-180360-0106

State File Number: 620

County: Beaver

Child's First Name: Theron

Child's Middle Name 1: Adams

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Morris

Child's Suffix:

Sex: Male

Month of Birth: 3

Day of Birth: 6

Year of Birth: 1912

Father's First Name: Andrew

Father's Middle Name 1: A

Father's Middle Name 2:

Father's Surname: Morris

Father's Title or Suffix:

Mother's First Name: Ellen

Mother's MIddle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Adams

Is there an Amendment?: No