81443-189326_0046

State File Number: 310

County: Weber

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: Male

Month of Birth (Number): 4

Day of Birth: 5

Year of Birth: 1914

Father's First Name: William

Father's Middle Name 1: V

Father's Middle Name 2:

Father's Surname: Couglass

Father's Title or Suffix:

Mother's First Name: Mary

Mother's Middle Name 1: E

Mother's Middle Name 2:

Mother's Maiden Name: Fawers

Is there an Amendment?: Yes

Document Type: Certificate of Birth