81443-180362-0621

State File Number: 389

County: Cache

Child's First Name: Lennis

Child's Middle Name 1: Gale

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Spanon

Child's Suffix:

Sex: Male

Month of Birth (Number): 8

Day of Birth: 21

Year of Birth: 1912

Father's First Name: Willard

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Spanon

Father's Title or Suffix:

Mother's First Name: Mabel

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Jensen

Is there an Amendment?: No