USA > Massachusetts > Franklin County > Leverett > Deposition - Births 1852-1918 > Part 6
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Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are true.
Clerk
Recorded
Of
(City or town.)
Mass.
Commonwealth of Classachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth
„.in the of of.
(Name of city or town.) (Name of child.) (('ity or town.)
does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorrectly stated in said record : -
Date of birth,
Name of child,
Sex,
Color,
Condition (twin, &c.),
Place of birth,
Name of father,
Maiden name of mother.
Residence of parents,
(at time the birth occurred.)
Occupation of father,
(at time the birth occurred.)
Birthplace of father,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and nuumber, if any.)
Relation to child, if any.
....
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are true.
Clerk.
(City or town.)
Recorded
Of
Mass.
Commonwealth of Massachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth .in the of of.
(Name of city or town.) (Name of child.) (City or town.)
does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorreetly stated in said record :
Date of birth,
Name of child,
Sex,
Color,
Condition (twin, &c.),
Place of birth,
Name of father
Maiden name of mother ...
Residence of parents,
(at time the birth occurred.)
Occupation of father,
(at time the birth occurred.)
Birthplace ot father,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are true.
Clerk.
(City or towu.)
Recorded
Of
Mass.
Commonwealth of Massachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth
of in the
_ _ of
(Name of child.)
(City or town.)
(Name of city or town.)
does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorrectly stated in said record : -
Date of birth,
Name of father,
Maiden name of mother,
Sex,
Residence of parents,
(at time the birth occurred.)
Occupation of father,
(at time the birth occurred.)
Condition (twin, &c.),.
Birthplace of father,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made
oath that the statements subscribed to by.
are true.
Clerk
(""ity or town.)
Recorded
Of
Mass.
"
Name of child,
Color,
Place of birth,
Commonwealth of Massachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
of
in the
(Name of city or town.) (Name of child.) (City or town.) of does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorrectly stated in said record : - -
Date of birth,
Name of father,
Maiden name of mother,
Sex,
Residence of parents,
(at time the birth occurred.)
Color,
Occupation of father,
(at time the birth occurred.)
Condition (twin, &c.),
Birthplace of father,
Place of birth,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear
above and made oath that the statements subscribed to by
are true.
(City or town.) Clerk.
Recorded
Of
Mass.
The undersigned on oath depose and say that the record relating to the birth
Name of child, ..
Commonwealth of Massachusetts.
No.
DEPOSITION
CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth
of. ... in the
(('Ity or town.) of . (Name of child.)
(Name of city or town.)
does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorrectly stated in said record : -
Date of birth,
Name of father,
Name of child,
Maiden name of mother.
Sex,
Residence of parents,
(at time the birth occurred.)
Color,
Occupation of father,
(at time the birth occurred.)
Condition (twin, &c.),
Birthplace of father,
Place of birth,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are true.
. Clerk.
Recorded
Of
(City or town.)
Mass.
Commonwealth of Massachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth in the of of
(Name of city or town.) (Name of child.) (City or town.)
does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorrectly stated in said record : -
Date of birth,
Name of child,
Sex,
Color,
Condition (twin, &c.),
Place of birth,
Name of father
Maiden name of mother ..
Residence of parents,
(at time the birth occurred.)
Occupation of father,
(at time the birth occurred.)
Birthplace of father,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are truc.
Clerk.
Recorded
Of
(City or town.)
Mass.
Commonwealth of Massachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
of
The undersigned on oath depose and say that the record relating to the birth in the
of.
(Name of child.)
(City or town.)
(Name of city or town.)
does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of faets omitted or incorrectly stated in said record : -
Date of birth,
Name of father,
Maiden name of mother.
Residence of parents,
(at time the birth occurred.) ......
Occupation of father,
(at time the birth occurred.) .....
Birthplace of father, ...
Place of birth,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made
oath that the statements subscribed to by
are true.
.Clerk.
Recorded
Of
(City or town.)
Mass.
Sex,
Name of child,
Color,
Condition (twin, &c.),
Commonwealth of Massachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth .in the
of (Name of child.) (City or town.) of (Name of city or town.) does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorrectly stated in said record :
Date of birth,
Name of child,
Maiden name of mother.
Sex,
Residence of parents,
(at time the birthi occurred.) ....
Color,
Occupation of father,
(at time the birth occurred.)
Condition (twin, &c.),
Birthplace of father,
Place of birth,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by. are true.
Clerk
Recorded
Of
(("ity or town.)
Mass.
Name of father,
Commonwealth of Massachusetts.
DEPOSITION
CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth
of ...
in the (Name of child.) ((ity or town.) of (Name of city or town.) does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of faets omitted or incorrectly stated in said record : -
Date of birth,
Name of child,
Maiden name of mother.
Residence of parents,
(at time the birth occurred.)
Color,
Occupation of father,
(at time the birth occurred.)
Birthplace of father,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are true.
Clerk.
Recorded
Of.
Mass.
Sex,
Condition (twin, &c.),
Place of birth,
Name of father,
(City or town.)
Commonwealth of Classachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
of
The undersigned on oath depose and say that the record relating to the birth .in the of (Name of child.) (City or town.) (Name of city or town.)
does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of faets omitted or incorreetly stated in said record : -
Date of birth,
Name of child,
Maiden name of mother.
Residence of parents.
(at time the birth occurred.)
Color,
Occupation of father,
(at time the birth occurred.)
Condition (twin, &c.),
Birthplace of father,
Place of birth,
Birthplace of mother,
SIGNATURE.
RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
...
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are true.
Clerk.
Recorded
Of
(City or town.)
Mass.
Name of father
Sex,
Commonwealth of Classachusetts.
No.
DEPOSITION CORRECTING RECORD RELATIVE TO A BIRTH. (St. 1897, Chap. 444, Sect. 14.)
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
The undersigned on oath depose and say that the record relating to the birth of in the of (Name of child.) (City or town.) (Name of city or town.) does not fully and correctly state all the facts relating to said birth, and that the following is a true statement of facts omitted or incorrectly stated in said record : -
Date of birth,
Name of father
Name of child,
Maiden name of mother,
Sex,
Residence of parents,
(at time the birth occurred.)
('olor,
Occupation of father,
(at time the birth occurred.)
Condition (twin, &c.),
Birthplace of father,
Place of birth,
Birthplace of mother,
SIGNATURE. RESIDENCE. (City or town, street and number, if any.)
Relation to child, if any.
Date,
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by are true.
Clerk.
(City or town.)
Recorded
Of
Mass.
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