FAMILY GHUUP NlJ.ThIs Inlormal/on Oblalned From:

nUSD811U ~rUIl••• f ••••••

v •• ,0", Monlh

Blrt" CI1r'ndIA ••.OulhBu,I.,

I~b!ilb

~u.A.A.,Y ~

5~ rtRj ~I, , ·

N,L. I

N,C.

Pile., 01 R.,.d.net

oC~2!!!..C!."!_~W-.t2':..·~::;::ill: :~:.~~o,(~.'j,~~,

Add Info on5'111 or Counlry

5t.l, or Counlry

ChurCh Allllla1lon

"'Olh ••••••• Id •• H.",. (" ~~ A-o...l t\)ooL. c.:e J(

Rf)bep-L5~I./n~ c

.-+--

Counly 01 P'OlrlnCI, Ilc.

Counly or Plo,lnc., .Ie

City. To .•••.n Of Plica

Clly, To •• n 0' PIIC'O.y 1A0nih Yur

D., "-"on In Y,I'

Mil.

BI,111 b.j- 1~.f.-4-

BI'II1 ·I~ reg, I

1,4 ••.

080111

Bu,lal

Blrll1 ~ In t.,-7

Bu"lt

D.llh

CI1,'nd

Occupilloll II oth.' thin hO\lu"..It.

~1.hlt·:~~::,~~:ti~~:r"ro,~~cl~'~~,tic.

H" Fllhl' T_l •.., \AJh i'T1e~

Wife's Full Malden Name c...e_ L , ~•.•,1,.D •••

HI' FIlh.,

ICnlldrt" ,0•••

1~'ThA~' tJ..e-.

F~' ~M':8~tJ~2M

iEt

Wif--

.".... --~~Hs~~r'.= I-fd1~~l

Compll.'<-.~~ Add'.,.~::i! ---~~ej Clly, 511"0'1'S••

i:;.~~I:~;;:n·~~;.·,,:,~~fl:h'

Deall1

Bu,I.1

3~ f~Full Nlml of

4 L OCDA~Full Nlml 01 SPOUII'

M~ ANIJ ~Will­5

Y~5Full Nlm. 01 SPOUII'

~..'rn~~ 5t.~S~~~6C;~~~.~~

Blrll1

Mlr.011111Burl.1Blrll1Mat.Delll1Bu,I,'

Blrll1

Mlr.

Deall1

Bu,ll'

Blrll1

lAIr.

~ 1~1I?J-tt•.. '-!PJ,,/I'" ~

Full N.m. D~U'" 011111

~~"'"'1~~:t-11>-~NkthA~ D ~_._I kt~I

'S.Jt),"-'., a,I

P,l.

~ •• A - tJt) JJ~ft­4-MI•.

Oull1

Bu,I.1

Mat.

Ahlh

011111

Bu'lal

~bJ.,. \ <64 ~•.

M.t.

BurIal

~Mlr,

001111

Bur'.1

;;;;U I ~ 1;'2.- -z..

Fun N.m. 01 5poUII

8,,~Y),5 T---±-P- I~ L .

19FU~~Ad~K ~KL.,tJ10

I r")1 U· __ •.•, Cr:nul.", u; ;,s ••._ ..••_,)

I

*7,

FAMILY GROUP NO. Husband's Full Name Th,f\IM~~12.This Intormatlon Oblalnod From; l:;:: •••• roo,

_____.!'!!~'L.10 ~ -------- ..S4Q.~_____ _ __•• . •..... Ch(~~ _ .__. •__ ._0 __ ' _ •.• ~_ _ ....• _

M.r.

NQWL:et.) ~ .J.~1- CcM I

O,,'h

BU""

PI.e •• or R."d.nc:e

ACId. Info. Oft H •••ebend

Chr'nd

~>---~-,~~-~~CX

OecuOlllon

~~n.~:~;::i,t::~~.iro/~.~~~~,.

His Falhor (' hCia ~

Add. In'o. on ¥tll.51111 0' Country

~llIt.,y Ale.

Church Affilialion

Chuteh Afflliition

MOlitor" M.ld.n Nom. Ce L, At. Rcbe Q:I5

Name R~~~IJ. A-N~

P~.a ,~ ) T Molh,,.. M,lde" Name

Clly, To••n or PlicaDay Monlh ,vur

i~ I/{(t.{)

Wife's Full Malden

Birth'

Pilei' 01RUld.ne.

8urlal

Occup.llon If other thin houJ.~If.

~~hk~~~;:r~~~si~~:,"ro,N.~c~'~~,t1C.Hor F.,hor (" _Q.O ,

Addr •••

Clly, 51.,.

Compuor

D.,.

s•• ChilO""', Nlm. In FUll(An. no. In ord.r or blrl"'l -1 g::~'I"1 Diy Monlh ."•• , City, Town or Pi,e. County or ProYI"c., elc. Sr.,. or Country Add. /nlo. on Child,..,

1/

(~

Jt-~-oY~ (j),J9i.~ I ,\ ~lo4 •

tS.

it~~~ 0 (\" C<Y\-

\'-

~,6YL'. ~cJ..1.

O,:J ~ •••It>'~ .. -

Blrlh

Mar.

Dealh

Burial

Blrlh

Mar,

D.alh

Bu,/al

B/rth

M.r.DUlhBurialBlrlhMar.Death8urlalBirthMar.DUlhBurialBirthMar,D.alhBurla'BlrlhMar,D.athBurialBirthMar.DUlh_L __ ·u

--- ..,

Full Namtof SpoU"·

Full Nlm. 01 'pou •• •

Full Nam, 01 Spoua,'

Full Nam, of Spoua.·

Full Nam, of Spoua,'

I'uil Nam,OfSpoua,'

MIV.1 J~ ~~tlOrdt\ <;.5

7

6

8

9

7uII NamlOl lpo" •• -

10

*

FAMIL Y GROUP NO. Husbanu ~ ruB Namet«W€,.LL. L.JiWd"t:.This Inlormatlon Obtained From:

••••••tI •••••O,y Monlh

r,.,Cfly. Tow" 0' P'UICoun1r 0' Provinci .• Ie51"101 CounhyAc:Ja 11"'0 0"0'1,

ShIhChr'ndMI'.Oulh

?Budai

Pllen of R'S.dlne.OC.~2.!!!..~~__

Chulch AHIII.llonMIIIIIIY R.e~~h..'~::;::;1'::~:.~~o,I~I.'c~~~,

HI' rlthll

MOlh'''' ••••112."Him,iIv\ ~ c1Q.-

A-N~w~j~ Wife's Full Malden Name

H

W,I"Day MonlhVu,Clly, To••n 0' PIIOICounly 0' Provine., .Ic511" or Counuy.••dd Infe0,1,

Sinh'-. II .. Ch.'nd

,f" 1'\11-~~-,~IO •• th,

",. Bu,'"d Compll"Pile., of RUld.ne.

§:! .••dd••••Occupallon II olh" thin hOUUNII,ChurCh Afllll.tlon.•1 ...9] Clly, SIll. ~~h:~ ~~;::.~:'i~~:tTo,k,~c'~'~~,lie

O.t.

H., Father Mol""'" '_hid." '11m,

5 ••

C""(JII" I ",ml ,,, Full

Iphlldrl" IO'Y

MonthV,., Cllt. Town 0' PI.e.Count, Of P,oylne., lie.Sl,tl Of CounltyAdd Inlo cIAu.no. In o,dll 01 blllhi 01'1

?- °LO(Qt:).. N ~M 1<'\5

Blrlh 11 ,J .••t:...c-_

:2. C\ ~~,-tti3~J.\ IIJJ..2... & •£:sf'.-

Mil . •Full N.m. of SpOUI.· Oeath

IJ.\. ~\)or~ \L1

.- ~ 'f\M)R-L,/1l"VTJ-Bu,I.1

f .-- Oh'~Blrlhi90~ 'll..V•••.•••\f ~ ,....---

.•.\{)~~ '0.•••••

1.41', Full N.m. 01 SP~u •• •Ottlh

:rl&.b~ I'15 ~ ...I ~u1~ .f) .~C~Bu,111

C

tJ~W~; tI~ ,"'t y' 1"."",,,·1ii0\/3f( r.

Blrlh1~-~ .•i'tOG.J... 1a.·U_ () Al,-.,a"P-r\hA~'~ b,<5..A Mil.

Full Nam. 0' Spou •• •Ottlh

~ .•s.m let i" • U••. , ,•••\r~r/"_~-....~l!.,.)W • ~. ~ - .\~ .••• ,'

It>

,.f'1':--r c:;,.", ,a~.t!. t,l..k./-~~Burial

4 Gt»)(Blrlh~I ITct\L) c •. u-Ii> """. lr-.

'if:,,~,l/A\ Mar.

ii-" It/I" ~"'&.,,.(\,. ~ ~

Full N.m. ol~poult'

.Ottlh

:50- 1h'"'\ C - - ...ItS !a. Burl.15el,lh

1.1."Full Nama 01 SPOUIt'

OttlhBu.lal6

Blnh

Mar.Full Nama 01 SPOUIt'Ottlh

Bu,lal7Birth

Mil.Full N.m. 01 SpOUIt'

OttlhBu,la'8

elrth"' ..,Full Nam. of SPOUIt'

OttlhBu.I.'9

Birth

1.1•• ,Full Nam. 01 Spou •• •Ottlh

au.l.r10Rlrlh.....•••• r.

Full Nam. or Bpnult'IIttlll.---- .

---

FAMIL Y GROUP NO.Husbanu:, t-ull Name J;"p.J~....1 ?=c\WIN

f\l<ltt) ~ ;This Information Obtained From:

•••••• tI. ••••••

D.y Monlh ru'Clly, Town Ot PI.,.Counf, Of P,oll'nc •.• reSUII Of CounlryAdd ''''0Oil'

Bhth

~, ~ l~~O{' ,•••. ,I}. LMrtc.NLl<..:TA. Ch,'nd

1,1.,.DuthBUfl.tPlle., 0' Rltldlne •OCCU~'!.~ B••t.)k.t.../ ~•..",,'I .•.0 •.ufCh Alflll'"on "'''Ullry Ale

2~h_'~;:;:~i,'::~~.~ro,'~.~?~~, ..His F.lhOl '"'t:'_..1 ••••,.

nT'ln~ Molh,,., U.Ic'.n Him,~..5M.~i

{po AL.. Fl )£1iN(~XIrAJ:"\"\TLrK fp Wife's Full Malden Name \

n~".tD.y Monlh YurClly, To••n or PI.CtCount{o, P/ollnc., .Ie51.1. 0' Counlry

.t.dd'lnl,Oil'

Birth'

] r ct.r 141'"

Ii.. Chr'nd

ej'1

Oulh~I",'I

Bu,ll'~i ComplierPile., 0' RUld.ne.e Lu\.l' L.l~Pi 1'1LJ.... 1 \ .Co~~! Add'".Oceupollon" olhOl thin hO"""Uo U-.~ ,.,.~l "!\'Ch "''''"ollon 8, s.~l .~j City, Sialo ~I::;~~::,'.~:'.~~:;To,~~ct~',:,~,.Ie

Oa'iH•• Fatho, L • 1J.••••.••1 Iv\\~ ••.""~MOl""·' Maldln Hlme -'.A .&.. I" -I _J".•...

So.

Chlldr'n. U,m, ,,..~ullIC""dr'n.

0 • ., Month YI.'Clly, Town 01 PI.CICounly or ProvlnCI. tic.Sta,. or CounlryAdd. InlofA".no. In O'd.r 01 blrlh) 0•••

~Q~\\) ~~\,IjN 1if

Birth~ -~ t q4 I1(' __"-' \L-L~M \T ('.\..,t) \r •.~MOl,

iq ~5"Full Nlmo or Spou.o'

D•• lhU-'- "'IA ~v..)~\...Burl.1

11lU G",,'\ Wh;T~cJ<-

BIl\hq~ I t.t4~\\...OM Ito.:<UILk-U:" JI\~Cu~Mil.

~ull Nlml Dr SpOU.I· Dllih~t~ - \ IL. ~-.."'LLBurtt'

--3

,Blrlhf '" - <c - 1'1l.f II\.L~~NY\.)tSU (,ht.~\"~~

AAD.n, £\Je.LvN ,--..IJ •••Mor.

Full Nlm"!f SpoutO' IDOIlhIWM, S. ~le~ Bu,'ol

l-n. "•.•c.

~l K~.cR.1 ~

BirthIL:, - to -lq47N-,L ft/.l~ c:::'~~'\V (i\. '-..<'A--Mil,

,0..".) "f

Full Nlmt of Spou •• •OoolhtJi:~.1'\_ •. 0 J U.I.J..t r-~d Bu,I.15

Bl'thMor.

Full Nlmo of Spou.I' OoothBu,I.16

BI,lh

1.40'.Full Ntml of Spou •• •

D•• lhBur't'7

Birth

Mor,Full Nlml 0' SpOU.I·

D.lthBu,lll8

Birth""r.Full Nlml 0' spou •• •

DOI.hBu,I.19

Blrlh

1.40',Full Nlmo 01 Spout.'

DllthBur,.110

IIf,th...Mar.Full N.m. of Bpnult' /101'"

rHIVlIL.. IunvurI-.V. Ilu;:)ua'iU ~ I \A1t "UIII'g' -.A. JPU',-'J; I \-t~~,~'"~This Information Obtained From:

" •••0 •••••O,y

MonlhY,I' Cllr, 10""''' Of PI.,.Counry Of Provlnc •. Ire5111' 01 CounttyAdd ''''0 00",'2~ .uoAt\J\ l.LL l~M~ < CI>,( f""A,.Bhlh'"

Chr'n~~ I lq4.~

1.111.

aGa "~.U ~~Dllih

BUII,IPile., 0' R'lld.ne.Oe.~2!~<!.':'_____

ChUIch AlIlIl'lion"'111111''1R.e

~I.h_';:~~::i,'~:~~.~ro,1~.I:l.~~,. ,,-

~

HI!.i4.th1l - '\": ••• .1._ ••.\ EdwiN•• n-"'\u 'h.,.•....Id.n HlmlZ-Vf.J,,;V/J C,tj)( fA)I\ 1'1.

1)Wife's Full Malden Namef\)ANc../U~cerJt-~~~ii

H

WI'"DayMonlhYII' City. To••n 01 PileiCoy{.IY 01 Plo"nCi. lieSllla or Country

J.dd Inl.0.11

Blrlh •

?-.. -~t (,t q..' )r' ...1•• .1.'- A-L

if

..Chr'nd

d"o•• lndl ",'Ourl.1~1 Compll.,

PIIC.t 01 R.tld.nce§! Addr •••Occupatio" It oth" (hln hOust~lf.Church .•••"III."on:!!

9JClly. 5'11' ~I:••'; ~:::,'.~~'.~:tlo,'~oac'~'~~,lie.

Olt.H•• F.'hll 1hhM A.~••••• J

""" - .\ •..• 'I. I•••••,O.n '"m. ~"+~LdLJ,J ft' l.t r.s••

CI'\I'C:h,n I thm, In Full

Ifhlldl1n ID.yMonlhy,., Cllv. liJwn 01 PIIC.Counly o. Province, ele.511" or CountryAdd InlofA".no' In o'Clef 0' bUI"1 0.1.

1CoAfJ.V3(;~~Blrlhtl1.c:.?L5fA .J~.~ ~/AlqAAJl,L-

1.4.,. Full Nama 01 YPOUII'

DuthBu,111

, &

·~,'-\.N\~S lJ ~N~~.JTBlllh

UJ.-Ill,.'-I Sl..lvtJvI} ••.- 1..Lf1..\v &rrA--Mar.

fI0I

Full Nlm. 01 SpOU•• •

DllihBurlll3

Blrlh

1.4.,.Full Nam. 01 SPOUII'

OulhBu,'.'4

Blrlh

Mil,Full Nlml 01 Spou •• •Death

Bu,lal5Birth

Mil.Full Nlml of Spou •• •

DealhBu,lal6

Bl'lh

Mar.Full Hlml 01 Spou •• •Dealh

Bu"117elllh

1.111.Full Nlml 01 Spou •• •Dllth

Bu,lal8BI,th

Mar.Full Nam. 01 apou •• •DlIlh

8uIIII9BI,th

Mar.Full Nlml 01 apou •• •Ollth

Bu,lal10II"'"

Mar.Full '11m. 01 Bpnu •• '1111110

....

iiIi~.f •.

...

FAMILV GROUP NO_ Husbanu:, r-ull Name 11 )~rD~\J.\\ } ~~iWAI'"~ gThis Information ObtaIned From; '0;:: •••• D.y Monlh YII' Clfy, lawn 0' P',co Counl, 0' P,ovlnc., .,c 51111 or Counlry Add In/o a

BIr'hl-:!O.~ ~\C> -r\ .Lt.•, -no I •• tb .~~Chr'nd

"'or. Q... 1<\" IOulh

Burl,'

Pilei' 01R,Sld,nCI

OCC:u~'!.~._ ChUfC.h .""1.1Ion "'1I1II.,y Rte

2~h.~:~;::i:::~~.~?o,t~.I:J.~~f

Hlt:!t\hlf Moth"·' ••••,Idln H.me

t! [12.' Wife's Full Malden Name leiGh MI1.C)F 1A}~Jhee~~~t ~;::. D.y Monlh rur Clly, To••n 01 Plac. Coun'y 0' P,ovlnc •. ,'c 51.,. or Country "dd Inl,; Bhlh • ~ q fGJlJ 7 6.'-~~" ~(. ~••,-::\\1 t:'.-..-- - , """"'J J. Chr'nd

~i OlOlh~i 8ull.1~~ COmpll., PIICII of R.sld,nce

~i Add'e,. Occup.l1on II olh" Ihln hO\.l" •••.U. ChUfCh 1..1111111100

e j Cl1y. SIIII ~I.h,,;~~~:r~~~ti~~:."ro/~~cl~t~~,"C0., •••• , FOIhor &:I2NP.~\ ~ INC!:-I "l)C) h ••.•~ ••,·••.••,••n '''me ~ ••• L , ~ ( .~e.2

5•• :;"':~I:~;::n'~~~.·,~f ~~,':h) Ig::'t'n I Diy ••••onlh V•• , Clly, Town 0' Prac. Counly 0' P,o.,lnce, elc. Sla,e or Country Add Info

1-r-, ,. \ \ '-n \) Blrlh J 9. I." \ 14t£L.t ~~A~ V ( ).,:,.1~ !oj, '" \1/ l ~~ Y\ r'\ W" \ \L..O(.••••••Mor. I ~ IFull N.m. 01 Spouu- Dealh )

Burl.1

2 BU~

Mil,

Full N.m. 01 Spouu' Ollih

Burl.1

3 BU~

Mor.

Full N.m. or Spou,,- Oulh

BUI,.I

4 Bhlh

MI(.

Full N.m, 01 SPOUII- Ollih

Burial

5 Birth

Mor.

Full Nam. 01 Spou"- Oulh

Bu,I.1

6 Birth

Mor.

Full N.m. 01 Spou,,- Ollih

Burl.1

7 Blr1h

Mor,

Full Nam. 01 Spou,,' Oellh

BUII.I

8 Bh~

Mlr,

Full N.m. 01 Spouu' O'"hBu,lal

9 Bhlh

Mar.

Full H.m. 01llpouu- Dnlh

BUII.I

10 Rhlh

M.,.

Full Nlm. or Bpou •• - IIlIlh