Please fill out this form as completely as possible

Prepared by:			Relationship to Husband:   Self Spouse/Partner Child Other Descendant (Granddaughter, etc.) Parent Other Ancester (Grandfather, etc.) Sibling Other Relative (Cousin, etc.) No relation
Email:	(Req.)		Page 1 of 1 1 of 2 1 of 3 2 of 2 2 of 3 3 of 3
Address:
City:
State:	AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO NE NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY      Zip:
(Your address will not be posted online)

You may: Post all of the following information on the Internet (be sure you have the permission of all living persons) Post this information on the Internet, but please do not post information for living persons Not post this information on the Internet    (Req.)

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Husband:

Occupation:

Religion:

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	Date (Day, Month, Year)	City	County	State or Country
Born:
Marriage:
Death:
Buried:					Cemetery Name:
Father:		Other Wives:
Mother:

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Wife:

Occupation:

Religion:

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	Date (Day, Month, Year)	City	County	State or Country
Born:
Death:
Buried:					Cemetery Name:
Father:		Other Husbands:
Mother:

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Children:

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Sex	Given Name(s)	Date of Birth (Day, Month, Year)	Location of Birth (City, County, State or Country)	Date/Location of Marriage Spouse	Date/Location of Death	Burial Location
1.
2.
3.
4.
5.
6.
7.
8.
9.

If there are more children, please fill out a second form. You only need to put the Husband and Wife's names, then the additional children. Also indicate the page number (above).
Do you have sources (birth certificates, census records, etc.) for any of this information? Yes No

Do you have pictures you would be willing to share? Yes No

Any further information you wish to share about this family?


     

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