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Department of Interior CHEROKEE NATION
Registration Department
P.O. Box 948
Tahlequah, OK 74465
- 3 -
APPLICATION FOR CERTIFICATE OF DEGREE OF INDIAN BLOOD
Complete the application in INK. List the name(s) of your ancestor(s), the tribe, the crrect roll number(s) from the FINAL ROLLS OF CITIZENS AND FREEDMEN OF THE FIVE CIVILIZED TRIBES. Cherokee Nation (Dawes Commission Roll Book) for the ancestor(s) listed with a blood degree and to whom you are tracing; and any CDIB reference. APPLICATIONS SUBMITTED WITHOUT ROLL NUMBER OR CDIB INFORMATION WILL BE RETURNED TO YOU. Use Ancestry Chart to assist you in filling out this form. PROCESSING TIME IS APPROXIMATELY FOUR TO EIGHT WEEKS!
APPLICATION INFORMATION:
1. __________________________________ 1a. __________________________________
Name at Birth and Current Name Mailing Address
1b. __________________________________ 1c. __________________________________
Date of Birth Place of Birth
1d. __________________________________
Social Security Number
PLEASE NOTE: If the ancestor has a CDIB, provide a copy of the ancestor(s) CDIB, only answer the questions to the CDIP ancestor(s), and skip to Question No.8
ANCESTRY INFORMATION:
2. ______________________________ _______________ ________________ ____________________
Name of Father Tribe Roll #/CDIB Living or Date of Death
3. ______________________________ _______________ ________________ ____________________
Name of Mother (Maiden Name) Tribe Roll #/CDIB Living or Date of Death
4. ______________________________ _______________ ________________ ____________________
Father's Father (Grandfather) Tribe Roll #/CDIB Living or Date of Death
4a. ______________________________ _______________ ________________ ____________________
Father 0f #4 (#8 from chart) Tribe Roll #/CDIB Living or Date of Death
4b. ______________________________ _______________ ________________ ____________________
Mother of #4 (#9 from chart) Tribe Roll #/CDIB Living or Date of Death
5. ______________________________ _______________ ________________ ____________________
Father's Mother (Grandmother) Tribe Roll #/CDIB Living or Date of Death
5a. ______________________________ _______________ ________________ ____________________
Father of #5 (#10 from chart) Tribe Roll #/CDIB Living or Date of Death
5b. ______________________________ _______________ ________________ ____________________
Mother of #5 (#1 from chart) Tribe Roll #/CDIB Living or Date of Death
6. ______________________________ _______________ ________________ ____________________
Mother's Father (Grandfather) Tribe Roll #/CDIB Living or Date of Death
6a. ______________________________ _______________ ________________ ____________________
Father of #6 (#12 from chart) Tribe Roll #/CDIB Living or Date of Death
6b. ______________________________ _______________ ________________ ____________________
Mother 0f #6 (#13 from chart) Tribe Roll #/CDIB Living or Date of Death
7. ______________________________ _______________ ________________ ____________________
Mother's Mother (Grandmother) Tribe Roll #/CDIB Living or Date of Death
7a. ______________________________ _______________ ________________ ____________________
Father of #7 (#14 from chart) Tribe Roll #/CDIB Living or Date of Death
7b. ______________________________ _______________ ________________ ____________________
Mother of #7 (#15 from chart) Tribe Roll #/CDIB Living or Date of Death