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| Personal Information Record Submittal Form |
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To submit information that may be used in the FAMILIES sections of this web site please fill in a separate form for each individual submitted- mother, father, child, spouse, family member and/or relative.
Please provide names, places, dates or any other information you feel pertinent or that you may wish to share. Every blank does not have to have an entry. |
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Is this Submittal to: (Please check one.) |
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Add New Information : |
Change Information : |
Delete Information : |
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| Family Surname: |
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Surname of Family Line |
PID Number of Individual |
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PID Number will be completed by batesar web master. |
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| Individual: |
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First Name |
Middle Name or (Nickname) |
Last Name |
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Day/Month/Year of Birth |
Place of Birth: Town, Township, County and State |
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Day/Month/Year of Death |
Place of Death: (Cemetary if known), Town, Township, County and State |
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| Father: |
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First Name |
Middle Name or (Nickname) |
Last Name |
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Day/Month/Year of Birth |
Place of Birth: Town, Township, County and State |
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Day/Month/Year of Death |
Place of Death: (Cemetary if known), Town, Township, County and State |
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| Mother: |
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First Name |
Middle Name or (Nickname) |
Last Name |
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Day/Month/Year of Birth |
Place of Birth: Town, Township, County and State |
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Day/Month/Year of Death |
Place of Death: (Cemetary if known), Town, Township, County and State |
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| Spouse 1: |
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First Name |
Middle Name or (Nickname) |
Last Name |
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Day/Month/Year of Birth |
Place of Birth: Town, Township, County and State |
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Day/Month/Year of Death |
Place of Death: (Cemetary if known), Town, Township, County and State |
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Date of Marriage |
Place of Marriage: Town, County and State |
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Number of Children this marriage: |
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*** Please Submit Information Form for Each Child. |
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| Spouse 2: |
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First Name |
Middle Name or (Nickname) |
Last Name |
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Day/Month/Year of Birth |
Place of Birth: Town, Township, County and State |
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Day/Month/Year of Death |
Place of Death: (Cemetary if known), Town, Township, County and State |
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Date of Marriage |
Place of Marriage: Town, County and State |
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Number of Children this marriage: |
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*** Please Submit Information Form for Each Child. |
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(Submit any pertinent information you may have about subjects below.) |
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Residence: Places and dates |
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Occupation: |
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Education: |
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Church: |
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Organizations: |
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Other Info: |
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Submitted By: |
Date: mm/dd/yyyy |
e-Mail Address |
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Send to batesar.com web site: |
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