Send to K.L.F.Rasmussen. Genealogy, 112 E. Broadway Ave., Yale, Oklahoma 74085
_________________________________________________________
- - - WIFE INFORMATION - - -

FULL NAME ______________________________________________________________________

MAIDEN    ______________________________________________________________________

BIRTH DATE & PLACE _____________________________________________________________

BAPTISM DATE & PLACE ___________________________________________________________

DEATH DATE & PLACE _____________________________________________________________

BURIAL DATE & PLACE ____________________________________________________________

CAUSE OF DEATH _________________________________________________________________

MOTHER'S FULL NAME (use maiden) ________________________________________________

FATHER'S FULL NAME _____________________________________________________________


- - - HUSBAND INFORMATION - - -

FULL NAME ______________________________________________________________________

MAIDEN    ______________________________________________________________________

BIRTH DATE & PLACE _____________________________________________________________

BAPTISM DATE & PLACE ___________________________________________________________

DEATH DATE & PLACE _____________________________________________________________

BURIAL DATE & PLACE ____________________________________________________________

CAUSE OF DEATH _________________________________________________________________

MOTHER'S FULL NAME (use maiden) ________________________________________________

FATHER'S FULL NAME _____________________________________________________________

MARRIAGE DATE & PLACE __________________________________________________________
MARRIAGE NOTES (Use back.)


DIVORCE DATE & PLACE ___________________________________________________________
DIVORCE NOTES (use back.)
(If either person remarried, include them along with children from that marriage.)


- - - CHILDREN - - - Include Birth Dates & Places (Use back if needed.)

1. ______________________________________________________________________________

2. ______________________________________________________________________________

3. ______________________________________________________________________________

4. ______________________________________________________________________________

5. ______________________________________________________________________________

INCLUDE SUCH INFORMATION IF KNOWN (OPTIONAL) - THIS IS A LIST OF EXAMPLES YOU CAN GET IDEAS FROM.
Adoptions, annulments, medical notes, research notes, census info, citizenships, color-race, court records, cremation info, divorces, education/graduation/degree info, emigrations, engagements, God parents, hobbies, immigrations, land records, military records, naturalizations, obituaries, occupations/retirement, pension info, physical descriptions, prison info, property info, religions, SSN of non-living, wills.

--- SUBMITTER INFORMATION ---

NAME ____________________________________________________________________________

ADDRESS,CITY,STATE,ZIP __________________________________________________________

                       __________________________________________________________

EMAIL ADDRESS ___________________________________________________________________

___________________________________________________________________________________________
PRINT NAME                               SIGN                              DATE
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