81443-180362-0613

State File Number: 385

County: Cache

Child's First Name: Maurice

Child's Middle Name 1: Edward

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Miles

Child's Suffix:

Sex: Male

Month of Birth (Number): 8

Day of Birth: 19

Year of Birth: 1912

Father's First Name: John

Father's Middle Name 1: E

Father's Middle Name 2:

Father's Surname: Miles

Father's Title or Suffix:

Mother's First Name: Mable

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Pulspher

Is there an Amendment?: No