LAWRENCE COUNTY, TN GENEALOGICAL SOCIETY
APPLICATION FOR A CERTIFICATE OF
FIRST FAMILIES OF LAWRENCE COUNTY, TN

(Information must be typewritten or neatly printed in black ink)

I, (Applicant's name as it will appear on Certificate) __________________________________________,
certify that I am a descendant of (Ancestor's Name) __________________________________________,
who resided in Lawrence County, Tennessee between the time period of 1817-1850 __; 1851-1900 __; or 1900-1950. (Check appropriate time period)

Gen. 1: I am the child of (father) _____________________________
Date born:
Place born:
Date married:
Place married:
(mother)_____________________________________ (mother's info below)
Date died:
Place died:

Gen. 2: The child of (father) ________________________________
Date born:
Place born:
Date married:
Place married:
(mother)_______________________________________ (mother's info below)
Date died:
Place died:

Gen. 3: The child of (father) _______________________________
Date born:
Place born:
Date married:
Place married:
(mother)_______________________________________ (mother's info below)
Date died:
Place died:

Gen. 4: The child of (father) ________________________________
Date born:
Place born:
Date married:
Place married:
(mother)_______________________________________ (mother's info below)
Date died:
Place died:

Gen. 5: The child of (father) _________________________________
Date born:
Place born:
Date married:
Place married:
(mother)_______________________________________ (mother's info below)
Date died:
Place died:

Gen. 6: The child of (father) __________________________________
Date born:
Place born:
Date married:
Place married:
(mother)_______________________________________ (mother's info below)
Date died:
Place died:

Gen. 7: The child of (father) _________________________________
Date born:
Place born:
Date married:
Place married:
(mother)_______________________________________ (mother's info below)
Date died:
Place died:

Attach Additional Sheets If Necessary

 



PROOF OF DESCENT
Identify each item of documentation used for each generation.
Number each sheet of documentation with the generation number it supports.

Gen. 1: ___________________________________________________________________________ _
___________________________________________________________________________________
___________________________________________________________________________________

Gen. 2:_____________________________________________________________________________
_______________________________________
____________________________________________
___________________________________________________________________________________

Gen. 3: _____________________________________________________________________________
_______________________________________
___________________________________________ _
__________________________________________________________________________________ _

Gen. 4: _____________________________________________________________________________
_______________________________________
___________________________________________ _
_______________________________________________________________________________ ____

Gen. 5: _____________________________________________________________________________
___________________________________________________________________________________
__________________                                                                                                                               _

Gen. 6: _____________________________________________________________________________
________________________________________________________________________________    _  ___________________________________________________________________________________

Gen. 7: _____________________________________________________________________________
_________________________________________
_______________________________________ __  
_________________________________________
_______________________________________ ___


I, the undersigned, ___ do or___ do not give permission to the Lawrence County Genealogical Society to publish my lineage, herewith submitted, in either their Lawrence County Heritage journal or a book on First Families of Lawrence County, TN. (Any material used will always have its source sited.)

___________________________________________
Typed or Printed Name of Applicant for Certificate

__________________
Date of Application

____________________________________________
Signature of Applicant

____________________________________________
Street Address City/State/Zip

____________________________________________
email address

_____________________________________________
Web Page URL

Send completed application and $10.00 check to:
Lawrence County Genealogical Society, 2588 Highway 43 S, Leoma, TN 38468



For any additional info or printed form send SASE the Lawrence County Genealogical Society.


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