81443-188580_265

State File Number: 59

County: Piute

Child's First Name: Arnold

Child's Middle Name 1:

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Brinkerhoff

Child's Suffix:

Sex: Male

Month of Birth (Number): 11

Day of Birth: 11

Year of Birth: 1914

Father's First Name: Raymond

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Brinkerhoff

Father's Title or Suffix:

Mother's First Name: Louise

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Heaps

Is there an Amendment?: No

Document Type: Certificate of Birth