81443-180362-0594

State File Number: 378

County: Cache

Child's First Name: Dorothy

Child's Middle Name 1:

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: MacDonald

Child's Suffix:

Sex: Female

Month of Birth (Number): 8

Day of Birth: 17

Year of Birth: 1912

Father's First Name: Edward

Father's Middle Name 1: LeClaire

Father's Middle Name 2:

Father's Surname: MacDonald

Father's Title or Suffix:

Mother's First Name: Mary

Mother's Middle Name 1: Amelia

Mother's Middle Name 2:

Mother's Maiden Name: Peart

Is there an Amendment?: No