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Transcription
What is your name?: Denver Sanders
What is your age? (years): 21 May 1, 1910
What is your occupation?: [Laborer?]
Where is your residence?: Criglersville Va.
Where were you born?: Criglersville
Are you married?: no
What was your wife's name before marriage?: -----
Are you married to more than one woman?: not any.
Have you children?: no
Do your wife and children enjoy good health?: ----
Are you sound in body?: yes
Are you subject to any periodic complaint which is liable to render you unable to follow your usual employment, or which is calculated to shorten life, and thereby render yourself, wife, and children a burden to this Lodge?:
Will you faithfully obey the laws and submit to all the penalties that may be imposed, should it ever be proved that you have made a false statement?: yes
Dated: Oct 10. 1931
Signed : D H Sanders
Witnessed: : Edmon Jackson
Witnessed: Robert Camel
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