81443-188585_749
Facsimile
Transcription
Status: Complete
State File Number REQUIRED: 2033
County REQUIRED: Salt Lake
Child's First Name:
Child's Middle Name 1:
Child's Middle Name 2:
Child's Middle Name 3:
Child's Surname:
Child's Suffix:
Sex: Female
Month of Birth (Number): 6
Day of Birth: 28
Year of Birth: 1914
Father's First Name: William
Father's Middle Name 1: George
Father's Middle Name 2:
Father's Surname: Simpson
Father's Title or Suffix:
Mother's First Name: Maxie
Mother's Middle Name 1: Audry
Mother's Middle Name 2:
Mother's Maiden Name: Owen
Is there an Amendment? REQUIRED: Yes
Document Type REQUIRED: Amendment or Supplement
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