81443-181554_0327

State File Number: 2000

County: Salt Lake

Child's First Name:

Child's Middle Name 1:

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname:

Child's Suffix:

Sex: Female

Month of Birth (Number): 7

Day of Birth: 6

Year of Birth: 1913

Father's First Name: Victor

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Peterson

Father's Title or Suffix:

Mother's First Name: Tilda

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Johnson

Is there an Amendment?: No

Document Type: Certificate