81443-188889_709

State File Number: 286

County: Summit

Child's First Name: Jessie

Child's Middle Name 1: Jerald

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname:

Child's Suffix:

Sex: Male

Month of Birth (Number): 12

Day of Birth: 26

Year of Birth: 1914

Father's First Name: Ralph

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Crittenden

Father's Title or Suffix:

Mother's First Name: Hazel

Mother's Middle Name 1: Matilda

Mother's Middle Name 2:

Mother's Maiden Name: Sargent

Is there an Amendment?: Yes

Document Type: Amendment or Supplement