81443-180362-0629

State File Number: 393

County: Cache

Child's First Name: Evan

Child's Middle Name 1: Grant

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Allen

Child's Suffix:

Sex: Male

Month of Birth (Number): 8

Day of Birth: 24

Year of Birth: 1912

Father's First Name: Alins

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Allen

Father's Title or Suffix:

Mother's First Name: Clara

Mother's Middle Name 1: E

Mother's Middle Name 2:

Mother's Maiden Name: Umlsey

Is there an Amendment?: Yes