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'<11'.1(.' e;pc C'7<;:'~~7 .YtHClINH\1 IN '1'1111 CIHC\.II',I' COU\\'I' I"OH 'I'll.\'l C'\',I'Y 0\" IlMll"l'ON, PAIl'!' :r:r " fjUSl\lI1 ~l^HTI!I /vluf\Hpr,l'I ~'\CJl\lH'HPN / Clllllpli\.1. 1\111\ I: Vll, III r)\1I1I\orJry No, ?,Ol.lli9 MJC111\ lilr, 'I'HIO'I'11Y ~1(lMI1I)()N, HunpondOI\\: " t~It[!\..ILJ~J!~ )llm 'l'It:t:13 Cf\l1fllil, 1111:\.0\1 lIi\H bnlll1 rO\JII.1,1\)71y rlonl,o \:od, 1\1/\ \.1\170[1 (111c1 PO I: I:Q,17 11O(\l71mJ, 0111110 01\ l:h 111 [lilY I:ll' 1)(1 I1lll\rd 1\PO\1 \:\In 11:1,1.l of: cOlllpln:l,nl:/ IIpon pl;rl[)1: or pro[lp]; find 1o(jnl oOl7V101l 01: [l1700pfJIl npon 1:\10 HUll p'ol)d[mtI npon 1:IHJ rlopol1:I,L:j,OIl!l 01: 11i\:IIO!lnOll on li'l1\llll.f. 01: l:\lo compl(,d,I)I\IJI:, 170'.I\,\1.nI71.y l:/.1I,OIl nl:l:017 p170pO\" L\11d lU~Jn1 1\01:1.uo l:o l:t1lJ llonponrllll1l: I 1.11.'01\ 1:\10 Hoport: 0 I: \:110 COlHlIlh1F.tiol1or in Chn\\Ool: f110cl hrJI:Il:l.n 01) l:ho' 317(1 ClllY oJ: li'olll:IH117Y, 1.9U3, 1\l1c1 W\1fl nr\/\\OI;l lJY c1Ot\l1uol, UPON CONfJ:!.J)1'l\U\'.I'10N WlIloJHmOJo', I:ho COlll7l: t:.i.nc1u f:r01\l I:ho ovidonoo, indopondonl:1.y of tho a~mlBHiol\fl of tho PQ~l:iaB :1.\1 tho p.1.o11cll,Pya or othond.BO, tho EolloVlJ.I1\l Euo\:fll Uil\l: tho CO\\lp1u1\111\1' uhcl Hoapondon t \10 ro.1Q\1J:11],1.y nHlrdot1 on tho .1.41:11 day of l~ob,"l1m:y, .1.979, :i.n Bun 1\111:on:l.o, 'I'C1XllfJ/ I.:hal: 1:11<-1 COlI\p1.ld.nunl: 11l und 'nuo boon c1ond,ailod J.n unci un no tl1n,\ bOI1L\f:.i.do 1700i,10n l: oj: l:hofH.n \:0 " of V.b7~/in:l.u for,l1Io1:'o thnn sh: (6) 1I\0nl:11u nC1XL: Pl7ooQcHn9 tho oomm0l10QI1Iont of: l:h1r. Huit, thnl: tho HOllponclont J.13 n 110n-l:.p'r1:l,d?nl.: of l:ho at"l:e oj! V:I,r(jin:I,f.\/ l:hnl: bnl:h \:ho compln:l,lH,nt nnd 1\00pondunL: Qro mOl1ilioru of: \:hoCnuoQu1al\ rUGD und ovor L:ho'~go of oigl1toon (.lll) yonl.'~1 t:1111l: tho compluilli~nl: :1./1 not u 11I01l\bor or:' tho J\1711\Cld ForoGo of'l:ho Unil.:od Sl.:ntoB of Amoriou/ thaI.: tho Hoaponc1ol\l: 18 " n mombor o:E tho l\17mLld \"'01:000 01' tho 1I1\:l..totl fll:Ul:O/3 of: l\l1Ior.i.oul thu l: l:h0170 wnll c;no (1) ohi.ld born of thi.f1 1\\I.\l:tiugo, nnI1l01:y, I, I...Awotrlou. WIIIN9 All" "Ullt,"hn Il"'-"'Totll VlhollH;" lJOSOI?\1 M10hnol MaguflBolJ, born l~obl:llury .1.3, 1900/ 1:l1l1t: t:\1(J pardos lasl: oohQb:l.t:orl \:ogol:hor LlLl hl1ubulJc1 Llnd \1.i.f(! on 017 about. ,J111y 21, 19111., :I,n \:ho City or I\nmpl:utJ, V:lr\liniu/ thnl: l:he purl:iofl ho);ol.:O ,hu\lo livlld sopnJ7nto nlll] npl\l:l: H.i.I:l1ont nllY aolwb.i.t:nt,J.ot) un,l w':l.L:hou. int:errlJptioll f:017 l\ POr:\,bel or I1\(Jro L-.lWIl 0\10 (1) yenq Dnel thLl L: " ..'" , , \:h~l fjompln.lnill1~, .Ill 1)111:.1 nod l:n \:1\0" rolJnJ' pl:nyod Em: .In hC,lI: 1.\i,11 oj: cO\llll':!.n.l. n I:, I' NOW, '1'111'11\1'1)"0111'1, Id\D cOl\rl, [101:11 AP,J\JIlO\o1, OlllJlo:I\ I\l1d 1l1'1(!Ill'a'i 1:1H1 [', [:1\[:1 CO\l\i'Ji\:Ll\illll:, iJ\JPNl ~lI\H.r 1'1 t'lnf\H\'lI,1'1 Ho\\l\fl}lON I I)n illld nhp 11()l:O\)Y :\.IJ, d.l.vDI,'cH.ld !l YJ!lP..!I.,\Y, m!L~.Um!'.llLl \:rnm 1:\\0 Ilmq>pl1l\un1', ~p:m\Aln, 'l'lNO'J'IIY Nnl(1\f1110N I nnd I1n f:rom hnr, IlI1C1Cll: [:ho P,\:ov.l.c!i,PI1U oj! flocll:.j:[lI1 ~O~~J:\:(D) (ill 01: 1:110 JOliO CJodo of' V~,rH.1.11J11/ n~J l\H\CJl1C'lo!'11 , IIn!'1 \:hlll: {,my, [JOll \::\.ncJon I: 1\I(\.I,':I,\:nl r.l.~Jhl:f\ h[)\:W~lOn tl1u Pl\1:\::I,0I1 nl:0 hural.lY ox 1:.I.nqn:Lnl1L'ld, :[ I: :111 f:lldl1or AD,WD(lI'll) f oHPloiHlnD .1I1t\ pr,:cHlnI1[J \:I\ilt t:l'0 (11\.1:0/ pl1ul:Otly nl1\,\ rmnl:.rol of: \:ho JnFnnl: ohild bO.1'l1 01: \:h:Ln I11n1'1:.1.'190, 1\11IHoly, ,'TtJ/loph ~l:I.Clhnlll Hol(I1I'lrml1, bo IIwnn'!ClC1 1:D tho CDIHP'],l1.i.l1l1l1t, w.l.t:11 rOl\oul\l,lblo Fi911\.',ri 01: v.l,a.l,I:nu'onl:oIWl:Vo[l nl1to 1:110 HOUlllJllrlon I: / \1n I:;\.:\. f\\1: 1:1)1l1: o1:dor or. \-.llo COIn: I: t I I: :1.13 f\1rthoj: 1/, " \)HpmHm\) \:l1l1t: \:ho l\onpondDll1: pny \1\1I:ol:ho ODl11pl.l1.1.1111n1: J!11l: I:ho f:I\1PPOJ:\: 11l1e1 11\/'I.I"Il\:on<l1100 Df 1:110 DI1.1.[] :I.lIJ:nl11: 011:1.1<'11:110 [l111H oj! , 'l'lll:oO llundrod I1l1d 00/100 DolI 111:13 (1)3()O, (0) por, 1\1DI1I:I1, in l\000l:" danoo wil:h \:\w 1:01.'1118 'of 1:\10 I1OJ:oilH1Fl:81: eloflor:tboc1 l\CjJ:oolnont:, uncI unt:l.l. f\\1:t:llol: 0.l:d01: oj! I:ho CD\ld I 1\nd :I.t: 1,lpponr:l.n9 t:lll1l; t:,l1o ),JC\1:I:.I,8p \wvo on I: 01:0 c1, in\:D 11, valirll1<jrooI11Dn.\: dn\:c.\t] .Jul.y.2?, IDOl, it: ;\,a horoby OHlWIHlUP, HI\'.\.'ID'I:lUlJ /'Ind l\l!'J~InMJilP <lilt] :l.nO[)rpOl:nI:8!'\' hO.l:o:l.n .1.11 oB J:Cwpaal:13 ,ill 1\OODI~e1nnoo w:Ll:ll't:ho p.t:Clvhd.DI1I3 of 800tion i!O~109 I 1. of t:llo 1950 CDda Df Vir9in~u, UP nIHondod, l\nd I:ho Pl1rt:.1.oa 110rot:D nro ordOl:oc1 t:D ODI\1p1y with :L ~,Il I:Ol:l\\U I Nol:ll:1.n~J fllr l:h(1):' rOl\1ld.I1:1.ll~J Eo bo dono :l.n t:h.i.13 Of-Il\ao, :l.t il3 Ol.'C1o.J:od t:hu t: \:110 Bl.lI\\O bo c:ti.f.II11:!:t.Jflocl lInd '13 t:d.a);on frDI\\ t:ho dool{Ol: oj: t:h i.~J CUll.\: I: I . , ' . -:2./ /' lnN'nm \:11i.B ....c4_4:--- t1ny uP. \7??'~t!(r7 ' 19,n3 I ~,;:::;(, , /' ._._,--_.~~ ~/, ~it~{'d.cUl7 ' ,H\t go // . {/ 11(;I01'IIfY Il1allhQ dQCIJ/111'lI1t 10 which t 1 6 alllhol1tle~lIol1ls' offlxbt Is 11 l'llO capy af 011 Ul'llllrlOll'ocard In " Iha HanlPtal1 Olrcult Caurl that I lAVO custady 131 tho rocal'd' b11d I oln Iho cllstadlon 01 that I'oeal'd. ;J '.nos p, t3ah laker, Cletll Oy ~ c<;t, A". 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