EARLIEST YEAR ANCESTOR LIVED IN SHELBY COUNTY ALABAMA: ____________
[Please attach copy of documentation of "Proof of Earliest Year" ancestor lived in Shelby County Alabama]
CERTIFICATE FEE: $20.00 for each submission
Please contact Bobby Joe Seales with questions concerning this form.
APPLICATION DATE: ______________________________________________ APPLICANT: ______________________________________________________________ Name as it will appear on certificate ______________________________________________________________ Mailing Address ______________________________________________________________ City State Zip TELEPHONE _____________________________________________________ E-MAIL ________________________________________________________ NAME OF ANCESTOR _______________________________________________________ Date of Birth: ______________________ Place: ______________________ Date of Death: ______________________ Place: ______________________ Date of Marriage: ___________________ Place: ______________________ SPOUSE: ________________________________________________________ (if female give maiden name, if known) Date of Birth: ______________________ Place: ______________________ Date of Death: ______________________ Place: ______________________List "SOURCES OF PROOF OF DIRECT DESCENT" for each generation. [Please number "Proof of Direct Descent" to correspond to each generation number.]
1. _________________________________________________________________ 2. _________________________________________________________________ 3. _________________________________________________________________ 4. _________________________________________________________________ 5. _________________________________________________________________ 6. _________________________________________________________________ 7. _________________________________________________________________ 8. _________________________________________________________________
LINE OF DIRECT DESCENT CHART 1. _______________________________ was born on __________________________ Applicant Day Month Year _______________________________ ___________________________ County State _______________________________________________ Spouse (if female, give maiden name) 2. Child of _________________________ Spouse _______________________________ Born ________________________ Place ____________________________ Married ____________________ Place ____________________________ Died _______________________ Place ____________________________ 3. Child of _________________________ Spouse _______________________________ Born ________________________ Place ____________________________ Married ____________________ Place ____________________________ Died _______________________ Place ____________________________ 4. Child of_________________________ Spouse _______________________________ Born ________________________ Place ____________________________ Married ____________________ Place ____________________________ Died _______________________ Place ____________________________ 5. Child of _________________________ Spouse _______________________________ Born ________________________ Place ____________________________ Married ____________________ Place ____________________________ Died _______________________ Place ____________________________ 6. Child of _________________________ Spouse _______________________________ Born ________________________ Place ____________________________ Married ____________________ Place ____________________________ Died _______________________ Place ____________________________ 7. Child of _________________________ Spouse _______________________________ Born ________________________ Place ____________________________ Married ____________________ Place ____________________________ Died _______________________ Place ____________________________ 8. Child of _________________________ Spouse _______________________________ Born ________________________ Place ____________________________ Married ____________________ Place ____________________________ Died _______________________ Place ____________________________