81443-180368-0656

State File Number: 348

County: Salt Lake

Child's First Name: Mildred

Child's Middle Name 1: Leone

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Robinson

Child's Suffix:

Sex: Female

Month of Birth (Number): 02

Day of Birth: 03

Year of Birth: 1912

Father's First Name: Frank

Father's Middle Name 1: Ambles

Father's Middle Name 2:

Father's Surname: Robinson

Father's Title or Suffix:

Mother's First Name: May

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Harrison

Is there an Amendment?: No