81443-180368-0719

State File Number: 374

County: Salt Lake

Child's First Name: Verna

Child's Middle Name 1: Estelle

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Schettler

Child's Suffix:

Sex: Female

Month of Birth (Number): 02

Day of Birth: 06

Year of Birth: 1912

Father's First Name: Clarence

Father's Middle Name 1: Lewellyn

Father's Middle Name 2:

Father's Surname: Schettler

Father's Title or Suffix:

Mother's First Name: Lorena

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Sorensen

Is there an Amendment?: No