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ADAMS COUNTY PIONEER DESCENDANTS APPLICATION

Please, type or neatly print. Review the Instructions.
Use the maiden name of a female spouse, unless it's not known.
For dates use day month year, as in: 9 Jun 1830.

1. My Earliest Adams County Ancestor was .

   He/she came to Adams Co. in and settled in .

   He/she was born on at ;

   Died on at ;

   Was married to

   on at .

2. Second Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

3. Third Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

4. Fourth Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

5. Fifth Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

6. Sixth Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

7. Seventh Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

8. Eighth Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

9. Ninth Generation: Their child was my

   Me! Parent Grand Parent G-G-Parent 2nd G-G-Parent 3rd G-G-Parent 4th G-G-Parent 5th G-G-Parent 6th G-G-Parent 7th G-G-Parent . He/she was born

   on at ;

   Died on at ;

   Was married to

   on at .

---

Name to appear on the Certificate:

Before mailing, review the Instructions once more. Mail completed applications and copies of evidence to:

Great River Genealogical Society,
c/o Quincy Public Library
526 Jersey Street
Quincy, Illinois 62301-3996

Application submitted by:

PERMISSION RELEASE I hereby give permission to the Great River Genealogical Society to reproduce the material herein submitted for the Adams County Pioneer Descendants for their publications and microfilming project.

Signed this ______________________day of ____________________________, 20_______

Signature_____________________________________________________________________

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