81443-180368-0704

State File Number: 367

County: Salt Lake

Child's First Name: Leonard

Child's Middle Name 1: Arthur

Child's Middle Name 2: Stenholm

Child's Middle Name 3:

Child's Surname: Hultquist

Child's Suffix:

Sex: Male

Month of Birth (Number): 02

Day of Birth: 05

Year of Birth: 1912

Father's First Name: Theodore

Father's Middle Name 1: R

Father's Middle Name 2:

Father's Surname: Hultquist

Father's Title or Suffix:

Mother's First Name: Jenny

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Stenholm

Is there an Amendment?: No