I
hereby give permission to the Illinois State Genealogical Society to reproduce
the material herein submitted for this Civil War Certificate for their
publication and microfilming projects.
Signature Date
Please Print or Type the Rest of Application
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VETERAN’S name(s): Doc # |
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Dates served in the Civil War: Doc # |
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Military Unit served in: Doc # |
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Dates served in Illinois Unit: Doc # |
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Dates and county of residence in Illinois: Doc # |
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Date and county of burial in Illinois: Doc # |
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APPLICANT’S name: (As it is to appear on certificate) |
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Address: |
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E-mail: |
1. I, was born on
at: City County State Doc #
and
married
who was born
on
at City County State Doc #
we married at City County State Doc #
2. I am the child of Doc #
who was born on at City County State Doc #
died
on at City County State Doc #
and
Doc #
who was born on at City County State Doc #
died
on at City County State Doc #
they married on at City County State Doc #
3. The said the child of Doc #
who was born on at City County State Doc #
died
on at City County
State Doc #
and
Doc #
who was born on at City County State Doc #
died
on at City County State Doc #
they married on at City County State Doc #
4. The said the child of Doc #
who was born on at City County State Doc #
died
on at City County State
Doc #
and
Doc #
who was born on at City County State Doc #
died
on at City County State
Doc #
they married on at City County State Doc #
5. The said the child of Doc #
who was born on at City County State Doc #
died
on at City County State
Doc #
and
Doc #
who was born on at City County State Doc #
died
on at City County State
Doc #
they married on at City County State Doc #
6. The said the child of Doc #
who was born on at City County State Doc #
died
on at City County State Doc #
and
Doc #
who was born on at City County, State Doc #
died
on at City County State Doc #
they married on at City County State Doc #
7. The said the child of Doc #
who was born on at City County, State Doc #
died
on at City County State
Doc #
and
Doc #
who was born on at City County State Doc #
died
on at City County State
Doc #
they were married on at City County State Doc #