ANCESTOR DATA SHEET

ANCESTOR # _____

Surname ______Other Spellings ______

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Given (First) Name ______Other Names/ ______

Spellings ______

Birth Date ______Birth Place ______

Marriage Date______Place of Marriage ______

Social Security Number ______

Church(es) Attended ______

Fraternal/Social Organizations ______

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ANCESTOR’S DEATH INFORMATION

Death Date: ______Place of Death ______

Date of Burial ______

Place of Burial ______

Church of Burial ______

Funeral Home of Burial ______

ANCESTOR’S SPOUSE

Surname ______Other Spellings ______

Given (First) Name ______Other Names/ ______

Spellings ______

Birth Date ______Place of Birth ______

Death Date ______Place of Death ______

Place of Burial ______

Church ______


Funeral Home ______


ANCESTOR’S IMMIGRATION INFORMATI0N

(from passenger lists/arrival records)

Port of Arrival ______Date of Arrival ______

Ship Name ______Destination in America ______

Going to? ______

Nationality ______

Last Residence in Europe ______Country of Origin ______

Naturalization Date ______Place ______

ANCESTOR’S SIBLING(S) INFORMATION

Name Birth Date Death Date Age at Death Sex (M/F)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

ADDITIONAL INFORMATION ______

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