81443-181555_1166

State File Number: 2792

County: Salt Lake

Child's First Name: Leroy

Child's Middle Name 1: David

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Martin

Child's Suffix:

Sex: Male

Month of Birth (Number): 9

Day of Birth: 20

Year of Birth: 1913

Father's First Name: Arthur

Father's Middle Name 1: L

Father's Middle Name 2:

Father's Surname: Martin

Father's Title or Suffix:

Mother's First Name: Estella

Mother's Middle Name 1: M

Mother's Middle Name 2:

Mother's Maiden Name: McComb

Is there an Amendment?: No

Document Type: Certificate