Society of Civil War Families of Licking County

Full name of applicant______________________________ Citizen of ______________
Address________________________________________________________________________
Applicant was born in________________________on_____________ Is the son/daughter of

 2.________________________________________born in_____________________________
on_________________and died in________________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in________________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:
                                                       
 3.________________________________________born in_____________________________
on_________________and died in_______________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in_______________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:

 4.________________________________________born in_____________________________
on_________________and died in_______________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in_______________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:

 5.________________________________________born in_____________________________
on_________________and died in_______________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in_______________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:

 6.________________________________________born in_____________________________
on_________________and died in_______________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in_______________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:

 7.________________________________________born in_____________________________
on_________________and died in_______________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in_______________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:

 8.________________________________________born in_____________________________
on_________________and died in_______________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in_______________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:

 9.________________________________________born in_____________________________
on_________________and died in_______________________________on_______________
and__________________________________his wife, born in_________________________
on_________________and died in_______________________________on_______________
Married in_____________________________on________________________that the said
___________________________________________was the son / daughter  of:


Ancestor is (no.__):  ____________________________________________________

         Names                 Date of Birth  To whom married
                                              (noting if married more than once)

PROOF OF DESCENT (title, author, page, Bible record, public records, or other sources)
2nd Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
3rd Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
4th Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
5th Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
6th Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
7th Generation :___________________________________________________________
________________________________________________________________________
________________________________________________________________________
8th Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
9th Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________

I married ______________________________on_____________at_________________
born _____________________ son/ daughter of ________________________________
My children____________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________




Phone__________________Signature________________________Date_____________
 

Applicants Name:______________________________________

Address______________________________________________

City/State____________________________________________

Phone number ________________________________________

LICKING COUNTY GENEALOGICAL SOCIETY

101 West Main Street

Newark, Ohio 43055

Phone 740-349-7480