NEW OR ADDITIONAL INFORMATION

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As of: _____________________ (Please enter a date)

Principal's Parents			Spouse's Parents
Father: __________ __________ __________	Mother: __________ __________ __________		Father: __________ __________ __________	Mother: __________ __________ __________
Ages when Principl was Born			Ages when Spouse was Born
AGE: _______	AGE: _______		AGE: _______	AGE: _______
Fill in Parents Page number if Known, leave blank otherwise.
PAGE:______________________			PAGE:______________________
The Principal
Principal			Spouse
Statistics	Name	Relationship	Name	Statistics
DOB:_____________ POB:_____________ DOD:_____________ POD:_____________ POI:_____________ EMAIL:___________	______________ ______________ ______________	MARRIAGE: DATE:_____________ PLACE:___________ DIVORCE: DATE:______________ PLACE:__________	______________ ______________ ______________	DOB:_____________ POB:_____________ DOD:_____________ POD:_____________ POI:_____________ EMAIL:___________
Children of this Union (In Chronologic Birth Order)
______________ ______________ ______________	______________ ______________ ______________	______________ ______________ ______________	______________ ______________ ______________	______________ ______________ ______________
STATISTICS: Fill in Statistics UNLESS separate form for Offspring's Family is submited
DOB:_____________ POB:_____________ DOD:_____________ POD:_____________ POI:_____________	DOB:_____________ POB:_____________ DOD:_____________ POD:_____________ POI:_____________	DOB:_____________ POB:_____________ DOD:_____________ POD:_____________ POI:_____________	DOB:_____________ POB:_____________ DOD:_____________ POD:_____________ POI:_____________	DOB:_____________ POB:_____________ DOD:_____________ POD:_____________ POI:_____________
For Add'l Children of this union or additional spouses (with or without additional children): Use both the back side and additional sheets

SOURCE: So we have a record of from where this information originated, please give your name and address (postal, E-mail or both): ______________________________________________________________________

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OCCUPATION/EMPLOYMENT:List address and responsibilities for both principal and spouse, as applicable. Also list various employments, if desired.

ADDRESS:List addresses for both principal and spouse, as applicable.

EDUCATION:List all levels of education for both principal and spouse, as applicable.

MEDICAL INFORMATION:List all known information (including cause of death) for both principal, spouse, and at-home children as applicable.

MILITARY INFORMATION:List dates of service, ranks and responsibilities for both principal, spouse and non-married children, as applicable.

COMMENTARY:List any additional information you might have on both the principal, spouse and at-home children - Use also back side

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