81443-180368-0647

State File Number: 344

County: Salt Lake

Child's First Name: Mary

Child's Middle Name 1: Louise

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Davis

Child's Suffix:

Sex: Female

Month of Birth (Number):

Day of Birth:

Year of Birth: 1912

Father's First Name: Joseph

Father's Middle Name 1: E

Father's Middle Name 2:

Father's Surname: Davis

Father's Title or Suffix:

Mother's First Name: Ethel

Mother's Middle Name 1: Blanch

Mother's Middle Name 2:

Mother's Maiden Name: Bunting

Is there an Amendment?: No