81443-180368-0709

State File Number: 370

County: Salt Lake

Child's First Name: Carrie

Child's Middle Name 1: Rosalind

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Woodmansee

Child's Suffix:

Sex: Female

Month of Birth (Number): 02

Day of Birth: 05

Year of Birth: 1912

Father's First Name: John

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Woodmansee

Father's Title or Suffix:

Mother's First Name: Rosalind

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Gidney

Is there an Amendment?: No