81443-188580_285

State File Number: 67

County: Piute

Child's First Name: Merlind

Child's Middle Name 1:

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Robinson

Child's Suffix:

Sex: Male

Month of Birth (Number): 12

Day of Birth: 22

Year of Birth: 1914

Father's First Name: Marcus

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Robinson

Father's Title or Suffix:

Mother's First Name: Eva

Mother's Middle Name 1: Estella

Mother's Middle Name 2:

Mother's Maiden Name: Dalley

Is there an Amendment?: Yes

Document Type: Amendment or Supplement