| Please fill out this form as thoroughly as possible and mail to: TIPCOA, P.O. Box 2464, West Lafayette, IN 47996 with a check for $4.00 for each obituary and a self-addressed return envelope. You may submit two requests per envelope. Not everyone had obituaries especially pre-1900's. We will do our best to help you and we will answer you or return your request if we don't find one. Good indexes start at 1901. |
Please submit a separate form for each person to be researched. Please print:
Your Name: _____________________________ Address: ______________________________
City: __________________________________ State: ________ ZIP: __________________
Phone: (______)_________________________ E-Mail: _______________________________
=================================================================================
Fill in information that can help below if you have it.
Ancestor's Name: ________________________________________________________________
Date of Birth: ________________________ Place of Birth: _________________________
Date of Death: ________________________ Place of Death: _________________________
Father: _______________________________ Mother: _________________________________
Spouse: _________________________________________________________________________
Marriage Info: __________________________________________________________________
Names of Children: ______________________________________________________________
_________________________________________________________________________________
received date_____________________________________________________________________