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Hi, I'm looking for information on Sarah CHILDRESS, who married Nathan GREER
in 1815 in Rutherford Co. TN, and died there in 1856. I have the names of
their children but I don't know anything else about her. Does anyone have her
listed as a sibling somewhere? I would like to find out more about her line.
Thanks
Lynne Norris
Reposted to Childress-L(a)Rootsweb.com
Subject:
Nancy Alice Childress
Date:
Thu, 25 Feb 1999 23:59:48 -0800
From:
"Diana Childress" <dianac(a)net-nerds.com>
To:
<london99(a)gte.net>
Found a Nancy Alice Childress, born April 16, 1871, died August 23,
1944, married to William Rader, born July 04,
1871 at Fields Creed, WV, died on October 16, 1929. Found this in the
book "6,474 Slack Relatives" by Rosco C.
Keeney Jr. (My 9th grade Civics teacher at Cedar Grove High School,
Kanawha County, WV)
Maybe this will help someone. Also have their children listed in the
book if anyone is interested.
Diana Childress dianac(a)net-nerds.com
Reposting to the Childress-L list
Dear FranAaron
You wrote: "There is a land record showing a William Childress sold land to William
Walker in 1797"
Do you have a copy or abstract of that deed? Where can I find it (county and
state)? The Walkers are relatives to President James K. Polk and some Walkers live
in the White House. This land sale may link William Childress to Sarah Childress
Polk, wife of the President. Your posting was a little confusing to read as it was
rejected because of HTML formatting. Can you send me the posting again to my
e-mail, <london99(a)gte.net>. That address will accept any formatting including HTML
and you shouldn't have any problem.
Thanks
Gary Childress
list owner
CHILDRESS-L-request(a)rootsweb.com wrote:
> >From CHILDRESS-L-request(a)rootsweb.com
>
> > This is a multi-part message in MIME format.
>
> > ------=_NextPart_000_0021_01BE5F32.1BFE3280
> > Content-Type: text/plain;
> > charset="iso-8859-1"
> > Content-Transfer-Encoding: quoted-printable
>
> > The logical father of Robert Uel, Jane A., Lucinda A., and John F. =
> > Childress is William in the 1830 census of Madison Co. AL. Jane=92s =
> > birth place is given as NC. In checking the census of NC the William =
> > listed here seems to be the only one it could be.=20
>
> > In the 1784-87 State Census of Surry Co. NC it gives the following =
> > people.
>
> > John Childress 1 6 2 2 3
>
> > Son of Henry and Mary Farmer Childress and moved to Davidson Co TN
>
> > Bought land from Abraham Fulkerson
>
> > John Faulkner 1 5 5 - -
>
> > Mary Childres - - 2 1 -
>
> > Wife of Henry Childress He changed to spelling to Childress
>
> > John Farmer 1 3 3 2 2
>
> > Think to many children to be her father most likely a brother
>
> > Charles Beaseley 1 2 2 - -
>
> > His daug. Nancy marries Elisha son of John Childress above
>
> > David Childress 1 - - - -=20
>
> > Son of Henry and Mary marries Lucy Gaines moves to Sullivan Co. TN
>
> > 1790 Census of Stokes Co NC
>
> > Mary Childress 1 - 2 - 1
>
> > At first thought the male to be Elisha. Land records show Henry sells =
> > land in 1797 So probably is Henry in the census
>
> > Charles Beasley 2 1 3 - 1
>
> > William Childress 1 1 1 - 1
>
> > Who is this William? Most likely is son of John Childress. He is gone by =
> > 1800. Could this be William Childress in Madison Co Al 1830. His daug. =
> > Jane Armstrong Peavy was born NC
>
> > There is a land record showing a William Childress sold land to William =
> > Walker in 1797. Does not whos land it borders. Need to get a better map =
> > to see the location of this land
>
> > James Walker 1 3 1 - 4
>
> > If anyone can make additions or corrections to this please let me know.
>
> > FranAaron(a)prodigy.net
>
> > ------=_NextPart_000_0021_01BE5F32.1BFE3280
> > Content-Type: text/html;
> > charset="iso-8859-1"
> > Content-Transfer-Encoding: quoted-printable
>
> > <!DOCTYPE HTML PUBLIC "-//W3C//DTD W3 HTML//EN">
> > <HTML>
> > <HEAD>
>
> > <META content=3Dtext/html;charset=3Diso-8859-1 =
> > http-equiv=3DContent-Type>
> > <META content=3D'"MSHTML 4.72.3110.7"' name=3DGENERATOR>
> > </HEAD>
> > <BODY bgColor=3D#b8b8b8>
> > <DIV>
> > <P>The logical father of Robert Uel, Jane A., Lucinda A., and John F. =
> > Childress=20
> > is William in the 1830 census of Madison Co. AL. Jane’s birth =
> > place is=20
> > given as NC. In checking the census of NC the William listed here seems =
> > to be=20
> > the only one it could be. </P>
> > <P>In the 1784-87 State Census of Surry Co. NC it gives the following=20
> > people.</P>
> > <P>John Childress 1 6 2 2 3</P>
> > <P>Son of Henry and Mary Farmer Childress and moved to Davidson Co =
> > TN</P>
> > <P>Bought land from Abraham Fulkerson</P>
> > <P>John Faulkner 1 5 5 - -</P>
> > <P>Mary Childres - - 2 1 -</P>
> > <P>Wife of Henry Childress He changed to spelling to Childress</P>
> > <P>John Farmer 1 3 3 2 2</P>
> > <P>Think to many children to be her father most likely a brother</P>
> > <P>Charles Beaseley 1 2 2 - -</P>
> > <P>His daug. Nancy marries Elisha son of John Childress above</P>
> > <P>David Childress 1 - - - - </P>
> > <P>Son of Henry and Mary marries Lucy Gaines moves to Sullivan Co. =
> > TN</P>
> > <P></P>
> > <P>1790 Census of Stokes Co NC</P>
> > <P>Mary Childress 1 - 2 - 1</P>
> > <P>At first thought the male to be Elisha. Land records show Henry sells =
> > land in=20
> > 1797 So probably is Henry in the census</P>
> > <P>Charles Beasley 2 1 3 - 1</P>
> > <P>William Childress 1 1 1 - 1</P>
> > <P>Who is this William? Most likely is son of John Childress. He is gone =
> > by=20
> > 1800. Could this be William Childress in Madison Co Al 1830. His daug. =
> > Jane=20
> > Armstrong Peavy was born NC</P>
> > <P>There is a land record showing a William Childress sold land to =
> > William=20
> > Walker in 1797. Does not whos land it borders. Need to get a better map =
> > to see=20
> > the location of this land</P>
> > <P>James Walker 1 3 1 - 4</P>
> > <P>If anyone can make additions or corrections to this please let me =
> > know.</P>
> > <P>FranAaron(a)prodigy.net</P></DIV></BODY></HTML>
>
> > ------=_NextPart_000_0021_01BE5F32.1BFE3280--
>
> Hi --
>
> The message you submitted to this list (included above) wasn't
> sent to the list subscribers. RootsWeb accepts only plain text
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Gary, Thanks for all the information you have given me. Since Mitchell
Childress is a collateral line for me, I have all the information that I
need. So I now ask to:
Unsubscribe
Pat White
I must apologize for my quick fingers and slow mind.
This William most likely would have been a brother of David Childress and uncle of Meredith.
Meredith was not born until circa 1800 and David supposedly married Annis _____ somewhere in the time frame of 1789. Oldest known child being Henry Mitchell Childress being
born about 1790 in SC as was Meredith per daughter, Callie in the 1880 census.
Therefore, we may have new fuel for the SC research.
Barbara
> >>> Hyacinth <digger1(a)flash.net> 2/24/99 10:49:45 PM >>>
> Here's hoping someone will find the wife and
> father of my William Childress
> b. Abt. 1750 d. abt. 1834 in Jefferson Co.
> Alabama married according to some researchers
> a widow named Snow.
--
Barbara Farthing Bonham
Summerville SC
Proud Supporter of Rootsweb
Terry,
Sorry about being so short...
The similarities are unbelievable. Check the children names, birthplaces etc.
I think I shall enter the data but give the weight in the notes.
Barbara
Terry Childress wrote:
> I hope you find a connection. If you do let me know. Looks like Mredith and William may be brothers, but no proof. Meredith is in my line (same line as Barbara Bonham).
>
> >>> Hyacinth <digger1(a)flash.net> 2/24/99 10:49:45 PM >>>
> Here's hoping someone will find the wife and
> father of my William Childress
> b. Abt. 1750 d. abt. 1834 in Jefferson Co.
> Alabama married according to some researchers
> a widow named Snow.
> Children:
> Mary b. Abt 1790 d. abt 1860 Choctaw Co. Ms.
> Obediah b. Oct 15, 1792 S.C d. Aug. 3, 1852
> Ackerman Ms. m. abt.1816 Selah Ayres
> David b. abt 1800 Al. m. Mary Graham
> Jefferson Co. Al June 13, 1819
> William b. ? S.C. d. July 9, 1853 Leon Co.
> Tx. m. Elizabeth York 1820
> Levi, b. Oct 28, 1805 S.C. d. feb 3, 1879
> Leon co., Tx. m. Susannah Montgomery May 3,
> 1824
>
> My line is Obediah, son of William.
> John son of Obediah, b. 1822 Al. d. dec 1859
> Winston Co. Ms. m. Narcissa Barron
> Obediah son of John, b. Dec. 17, 1846 Choctaw
> Co. Ms. d. Feb 11, 1936 Blackfoot Village,
> Anderson co. Tx. m. (1) Martha Ann Missouri
> Baskin m.(2) Georgianna Matilda Baskin (
> they were sisters) he had 5 children by wife
> (1) and 6 children by wife (2)
> I have most lots of info about all the others
> in this line, but need to put a wife with
> William and find him a father.
>
> Royce Lynne Larson
>
> ==== CHILDRESS Mailing List ====
> To Unsubscribe write only one word in the body of the message
> UNSUBSCRIBE and e-mail to either
> CHILDRESS-L-request(a)rootsweb.com or CHILDRESS-D-request(a)rootsweb.com
>
> ==== CHILDRESS Mailing List ====
> To see previous Childress mail list postings archived at Rootsweb go to
> http://searches.rootsweb.com/cgi-bin/listsearch.pl
--
Barbara Farthing Bonham
Summerville SC
Proud Supporter of Rootsweb
Terry,
Note the son, David...
Terry Childress wrote:
> I hope you find a connection. If you do let me know. Looks like Mredith and William may be brothers, but no proof. Meredith is in my line (same line as Barbara Bonham).
>
> >>> Hyacinth <digger1(a)flash.net> 2/24/99 10:49:45 PM >>>
> Here's hoping someone will find the wife and
> father of my William Childress
> b. Abt. 1750 d. abt. 1834 in Jefferson Co.
> Alabama married according to some researchers
> a widow named Snow.
> Children:
> Mary b. Abt 1790 d. abt 1860 Choctaw Co. Ms.
> Obediah b. Oct 15, 1792 S.C d. Aug. 3, 1852
> Ackerman Ms. m. abt.1816 Selah Ayres
> David b. abt 1800 Al. m. Mary Graham
> Jefferson Co. Al June 13, 1819
> William b. ? S.C. d. July 9, 1853 Leon Co.
> Tx. m. Elizabeth York 1820
> Levi, b. Oct 28, 1805 S.C. d. feb 3, 1879
> Leon co., Tx. m. Susannah Montgomery May 3,
> 1824
>
> My line is Obediah, son of William.
> John son of Obediah, b. 1822 Al. d. dec 1859
> Winston Co. Ms. m. Narcissa Barron
> Obediah son of John, b. Dec. 17, 1846 Choctaw
> Co. Ms. d. Feb 11, 1936 Blackfoot Village,
> Anderson co. Tx. m. (1) Martha Ann Missouri
> Baskin m.(2) Georgianna Matilda Baskin (
> they were sisters) he had 5 children by wife
> (1) and 6 children by wife (2)
> I have most lots of info about all the others
> in this line, but need to put a wife with
> William and find him a father.
>
> Royce Lynne Larson
>
> ==== CHILDRESS Mailing List ====
> To Unsubscribe write only one word in the body of the message
> UNSUBSCRIBE and e-mail to either
> CHILDRESS-L-request(a)rootsweb.com or CHILDRESS-D-request(a)rootsweb.com
>
> ==== CHILDRESS Mailing List ====
> To see previous Childress mail list postings archived at Rootsweb go to
> http://searches.rootsweb.com/cgi-bin/listsearch.pl
--
Barbara Farthing Bonham
Summerville SC
Proud Supporter of Rootsweb
I hope you find a connection. If you do let me know. Looks like Mredith and William may be brothers, but no proof. Meredith is in my line (same line as Barbara Bonham).
>>> Hyacinth <digger1(a)flash.net> 2/24/99 10:49:45 PM >>>
Here's hoping someone will find the wife and
father of my William Childress
b. Abt. 1750 d. abt. 1834 in Jefferson Co.
Alabama married according to some researchers
a widow named Snow.
Children:
Mary b. Abt 1790 d. abt 1860 Choctaw Co. Ms.
Obediah b. Oct 15, 1792 S.C d. Aug. 3, 1852
Ackerman Ms. m. abt.1816 Selah Ayres
David b. abt 1800 Al. m. Mary Graham
Jefferson Co. Al June 13, 1819
William b. ? S.C. d. July 9, 1853 Leon Co.
Tx. m. Elizabeth York 1820
Levi, b. Oct 28, 1805 S.C. d. feb 3, 1879
Leon co., Tx. m. Susannah Montgomery May 3,
1824
My line is Obediah, son of William.
John son of Obediah, b. 1822 Al. d. dec 1859
Winston Co. Ms. m. Narcissa Barron
Obediah son of John, b. Dec. 17, 1846 Choctaw
Co. Ms. d. Feb 11, 1936 Blackfoot Village,
Anderson co. Tx. m. (1) Martha Ann Missouri
Baskin m.(2) Georgianna Matilda Baskin (
they were sisters) he had 5 children by wife
(1) and 6 children by wife (2)
I have most lots of info about all the others
in this line, but need to put a wife with
William and find him a father.
Royce Lynne Larson
==== CHILDRESS Mailing List ====
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Hello Hyacinth,
No doubt that most likely your William Childress was related to Meredith
Childress who married Serena Harmon 2 Feb 1828 in Jefferson County.
According to sources passed along to me, Meredith was the son of David
Childress. David died in Humphries County, Tennessee supposedly 1850.
I only show one other son but am, told there were many children.
I will gladly share my data for Meredith and his descendants as I have
them with you or anyone should you find a connection.
Maybe this is a lead....I don't know but I wish you good luck anyhow.
Hyacinth wrote:
> Here's hoping someone will find the wife and
> father of my William Childress
> b. Abt. 1750 d. abt. 1834 in Jefferson Co.
> Alabama married according to some researchers
>
--
Barbara Farthing Bonham
Summerville SC
Proud Supporter of Rootsweb
Here's hoping someone will find the wife and
father of my William Childress
b. Abt. 1750 d. abt. 1834 in Jefferson Co.
Alabama married according to some researchers
a widow named Snow.
Children:
Mary b. Abt 1790 d. abt 1860 Choctaw Co. Ms.
Obediah b. Oct 15, 1792 S.C d. Aug. 3, 1852
Ackerman Ms. m. abt.1816 Selah Ayres
David b. abt 1800 Al. m. Mary Graham
Jefferson Co. Al June 13, 1819
William b. ? S.C. d. July 9, 1853 Leon Co.
Tx. m. Elizabeth York 1820
Levi, b. Oct 28, 1805 S.C. d. feb 3, 1879
Leon co., Tx. m. Susannah Montgomery May 3,
1824
My line is Obediah, son of William.
John son of Obediah, b. 1822 Al. d. dec 1859
Winston Co. Ms. m. Narcissa Barron
Obediah son of John, b. Dec. 17, 1846 Choctaw
Co. Ms. d. Feb 11, 1936 Blackfoot Village,
Anderson co. Tx. m. (1) Martha Ann Missouri
Baskin m.(2) Georgianna Matilda Baskin (
they were sisters) he had 5 children by wife
(1) and 6 children by wife (2)
I have most lots of info about all the others
in this line, but need to put a wife with
William and find him a father.
Royce Lynne Larson
I just recently subscribed to the mailing list. I am Darrell Childress and
am looking for further information. At this time, the furthest back I can
go is my grandparents. There were Lewis E (Edward or Eugene) and Lona Lloyd
Childress. I'm not even sure if Lewis was his first or middle name. They
lived in Brookneal, VA until their death. I can try to get more information
if necessary.
Thanks,
Darrell Childress
Lynchburg, VA
Hi Darrell,
I did the following search.
I went to the Map Site at <http://mapping.usgs.gov/www/gnis/gnisform.html> and
typed in "Brookneal" and "Virginia" to find out what county in Virginia,
Brookneal is in. (I am in California and am ignorant of places east of Las
Vegas). The Map Site is for the US Government's Geographic Service and is very
useful with esoteric map names and locations. Unless you can memorize a map of
the US, it has been useful for me to bookmark that site for future reference.
The search button found that Brookneal is in Campbell County VA.
I then went to a site that has a list of Virginia Counties at
<http://vitalrec.com/vacounties.html> that gave me the address of the County
Clerk in the Campbell County Courthouse as the following:
Campbell County Clerk
P.O. Box 7
Rustburg, VA 24588
(804) 332-5161
If there are any records on your Campbell County kin, they are apt to be on
file at that Courthouse. I would write them a letter giving them what you
approximate is the date of death of you grandfather. On that death certificate
you should be able to find the name of his father (your great grandfather and
the place of death of this great grandfather). You can then repeat the process
for the great grandfather, by writing to the courthouse in the county and state
of his death to get his death certificate). This procedure will work until
your research pre-dates the death certificate records in the courthouse (not
all counties and states kept death records prior to late 1800's or circa
1900). But at least it gives you the start... someone who dies in 1900 may
have been born in the early 1800's. (I take it that you have exhausted all
useful information from you living family members).
There are approximately 10,000 families in the US today with the Childress
surname. There are approximately 130 Childress researchers on this list (that
may sound small but 130 can collectively do a ton more than each of us
individually. A lot of the 130 researchers are going to be related... but how
is yet to be determined and the links won't become apparent until you get
closer to the 1800 century mark). Welcome to the fight. Does anyone else have
any information, success stories, brick walls or insights to add?
P.S. I have written to Childress families in the UK to see if they will join
the list. (But to date I have been able to find only 5 Childress families in
the telephone directory anywhere in the UK... compared to 10,000 in the US.)
They must have left (or I need a better search engine).
Gary Childress
Darrell Childress wrote:
> I just recently subscribed to the mailing list. I am Darrell Childress and
> am looking for further information. At this time, the furthest back I can
> go is my grandparents. There were Lewis E (Edward or Eugene) and Lona Lloyd
> Childress. I'm not even sure if Lewis was his first or middle name. They
> lived in Brookneal, VA until their death. I can try to get more information
> if necessary.
>
> Thanks,
> Darrell Childress
> Lynchburg, VA
>
> ==== CHILDRESS Mailing List ====
> To Unsubscribe write only one word in the body of the message
> UNSUBSCRIBE and e-mail to either
> CHILDRESS-L-request(a)rootsweb.com or CHILDRESS-D-request(a)rootsweb.com
i am looking for info on my grandfather[kermit carroll childress]from either
marion,va or chile high,va.born in the 1930`s.his parents was charles reed
childress and sena ethel hankley[childress].both born in the late
1880`s-90`s.charles reed`s father was james childress,who died in 1937.kermit
married geraldine virginia patterson whose parents were franklin winfield
patterson and florence schaffer martin.any info would be greatly
appreciated.thanks.....likeamu(a)aol.com
To Post to the Childress list use the address <Childress-L(a)Rootsweb.com>
Rootsweb computers reject messages that are not in "plain text only".
They do this to avoid spamming messages..... so it restricts
some forms of messages and some forms of GEDCOM files from being posted
directly to the list.
You can always send these 'enriched text' types of files to each other
privately, but you'll have to change the setting on your software in
order to send them to the CHILDRESS-L(a)Rootsweb.com address.
I use Netscape software and it gives me a choice just before I send
the message to send in "plain text only" and not HTML . But you can
also adjust your software program with a few clicks of a button. Below
is a Web site that tells you how to do that for a number of software
programs.
How to Turn OFF HTML or RTF in Various E-mail Software Programs
http://www.rootsweb.com/rootsweb/listowners/html-off.htm
Gary Childress
List Owner
Looking for information on George William Childress of Knoxville, Tennessee.
George was married to Bessie Myrtle Sexton. Do not know dates. He had
either thirteen or fourteen children. One son, the rest daughters. Believe
he died in 1950's. This is my husband's grandfather, whom he visited when
he was eight or nine. He said there were cousins everywhere around, so
someone must have some information.
Thank you.
Diana Childress dianac(a)net-nerds.com
Hello dianac(a)net-nerds.com,
Can you repost your inquiry about George Childress to the address
<Childress-L(a)rootsweb.com>. Do you have any dates of him? This is the
first time I have seen a George in Knoxville.
Thanks
Gary Childress
List Owner
PS The address Childress-L(a)Rootsweb.com is dedicated for posting to
the list.
The address Childress-L-request(a)Rootsweb.com is used for
subscribing and unsubscribing (i.e. a direct line to the administration
at rootsweb central, wherever that is,
and messages sent there won't get posted)
Joyce, I have a Robert Smith Childress in my line born about 1834 who
married a Margaret Cook. His father was Meredith Childress. mary
----------
> From: Joyce Bunch <rosejoy(a)mindspring.com>
> To: CHILDRESS-L(a)rootsweb.com
> Subject: [CHILDRESS-L] Robert Childress
> Date: Wednesday, February 10, 1999 9:32 PM
>
> I am looking for info on Robert Childress, my great grandfather, born
abt.
> 1831. He married Massey H Boyd from Carroll Co, VA. 1880 Patrick Co VA
> census states that he was born in SC. Anyone have any connections???
>
> Joyce
>
> I am a NC reunited adoptee.
> http://members.aol.com/joyrn60000/nurse.html
> http://members.aol.com/joyrn60000/gene.html (GENEALOGY)
>
>
>
> ==== CHILDRESS Mailing List ====
> To Unsubscribe write only one word in the body of the message
> UNSUBSCRIBE and e-mail to either
> CHILDRESS-L-request(a)rootsweb.com or CHILDRESS-D-request(a)rootsweb.com
Seeking information about this family found in the 1880 Bosque County, TX
census:
Childress, Rufus G. 42 Just. of Peace AL / SC / SC
Mary A. 36 wife MS / SC / SC
Fannie 12 dau MS / AL/ MS
Rufus T. 10 son MS / AL / MS
Minta 4 dau TX / AL /
MS
John 1 son TX / AL /
MS
Rufus was a county judge in Bosque County during the early 1880'S.
Interested in corresponding with anyone researching his line.
Thanks,
Ruth Cottrell
cotrell(a)gte.net
Hya !
I am Dan Matney, I have several lists here too, and also Childress in
our tree in several places.
I have been a little quiet but I am here. I am an Oregon Researcher and
the Gen Web Co. for Kla Co.
Also.
Now I really hate it when a state cant compley like others but it
happens, well I have also faced this problem, but here in Oregon we dont
have , we support genealogy, and if you need some reearch done in Oregon I
will freely listen to your query. Also I can get the death certs 1906 to
1948 for 25 cents and later ones for $14but then it requires a simular
thing as London put here.
Most all other data is free, and I am not a paid reseacher, I do it as
a favor when I am on location. I do have a lot off access.
If you would like to have the Childress info just ask
Just thought I would drop in and say Howdy ;)
Dan
http://www.angelfire.com/or/matney
----------
> From: london99(a)gte.net
> To: CHILDRESS-L(a)rootsweb.com
> Subject: [CHILDRESS-L] Death Certificates
> Date: Friday, February 19, 1999 1:33 PM
>
> To the Childress List Members,
> It can be a little difficult sometimes to get a death certificate since
> the state requires a reason. Apparently, "genealogical research"
> doesn't motivate some state agencies to release records. >>SNIP<<
To the Childress List Members,
It can be a little difficult sometimes to get a death certificate since
the state requires a reason. Apparently, "genealogical research"
doesn't motivate some state agencies to release records. Perhaps
answers like, "clearing ownership title" (land titles have to be traced
to their origins, even back hundreds of years) or "resolving probate"
might be more acceptable to them. Death certificates can show the name
of the parents of the deceased and where those parents lived. You can
then repeat the process, using the newly discovered information, for the
next generation of ancestors. Any comments are welcome by anyone.
Below is the reposting from another mail list:
Gary Childress
List Owner
Rootsweb Childress Surname Mail List
"My past experience with Virginia was that you could not get death
certificates from the State."
Generally, if a person has been dead for longer than 50 years, you can
get the
death certificate if you fill out the form and give a reason for wanting
the
document.
xxxxxxxxx
Commonwealth of Virginia
Application for Certification of a Vital
Record
Virginia statutes require a fee of $8.00 be charged for each
certification of
a vital
record or for a search of the files when no certification is made.
Please
make check
or money order payable to State Health Department. There is a $15.00
service
charge for returned checks.
****************
BIRTH
Number of Copies:
Paper:__________
Plastic Card:__________
Name at Birth:_____________________________________________________
If name has changed since birth due to adoption, court order, or
any
reason
other than marriage please list changed name here:
______________________________________________________________
Date of Birth:______________________________ Race:_______ Sex:_______
Place of Birth (City/County in
Virginia):___________________________________
Hospital of Birth:___________________________________________________
Full Maiden Name of Mother:_________________________________________
Full Name of Father:________________________________________________
DEATH
Number of Copies:_______
Name of Deceased:________________________________________________
Date of Death:_______________ Age at Death:_______ Race:______Sex:_____
Place of Death (City/County in
Virginia):_________________________________
Hospital Name:____________________________________________________
MARRIAGE
Number of Copies:_______
DIVORCE
Number of Copies:_______
Full Name of Husband:______________________________________________
Full Name of Wife:__________________________________________________
Marriage - Date:_______________ Place:_______________________________
Divorce - Date:________________ Place:_______________________________
(Ci
ty/County in Virginia)
If Marriage, place where license was
issued:______________________________
****************
Name of Requester:________________________________________________
Daytime Phone Number:_____________________________________________
Address:_________________________________________________________
City:_________________________ State:_________________ Zip:__________
What is your relationship to the person named on the certificate?
______________
If you are not the person named on the certificate, please state your
direct
and
tangible interest in receiving this
certificate:_______________________________
________________________________________________________________
I understand that making a false application for a Vital Record is a
FELONY
under
state and federal law.
Signature of Applicant:______________________________________________
Send completed application to:
Division of Vital Records
P. O. Box 1000
Richmond, Virginia 23208-1000
Please indicate the address you wish the certificate(s) mailed to in the
space
below.
_____________________________
_____________________________