81443-180368-0700

State File Number: 366

County: Salt Lake

Child's First Name: Michael

Child's Middle Name 1: L

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: DeLury

Child's Suffix:

Sex: Male

Month of Birth (Number): 02

Day of Birth: 05

Year of Birth: 1912

Father's First Name: George

Father's Middle Name 1: P

Father's Middle Name 2:

Father's Surname: DeLury

Father's Title or Suffix:

Mother's First Name: Ada

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Barton

Is there an Amendment?: No