|
First___________________ Middle
___________________Last Name______________________
Birth date: __________________________ (spell
out the month) Maiden Name_____________
Birth location:
City________________County_______________State______Country__________
Death
date:___________________________________________________(spell out the
month)
Death location:
City_______________County_______________State______Country__________
Marriage date:
________________________________________________(spell out the month)
Marriage location:
City_____________County______________State______Country__________
Father’s full
name:_______________________________________________________________
Mother’s full name (include maiden
name:___________________________________________
Siblings’ full
names:______________________________________________________________
_______________________________________________________________
|