81443-180374-0259

State File Number: 3056

County: Salt Lake

Child's First Name: Edwin

Child's Middle Name 1: Eugene

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Brooks

Child's Suffix:

Sex: Male

Month of Birth (Number): 11

Day of Birth: 01

Year of Birth: 1912

Father's First Name: Edwin

Father's Middle Name 1: Uriah

Father's Middle Name 2:

Father's Surname: Brooks

Father's Title or Suffix:

Mother's First Name: Laverne

Mother's Middle Name 1: Kathryne

Mother's Middle Name 2:

Mother's Maiden Name: Johnson

Is there an Amendment?: No