0438_380C1. PLACE OF 0, IRT H TEXAS DEPARTMENT OF HEALTH
STATE OF TEXAS BUREAU OF VITAL STATISTICS
CERTIFICATE OF BIRTH
COUNTY OF
CITY or.
PrZECINCT NO.
CIVZ STrZrT AND NUMOMR OR NAMM OF INSTITUTION
a G
n. ffULL NAMM Orf C-;4fLn-- , a .1. 1., n
3. OCA
FO,'l PLURZAL DIrTHO ONLYi
G. LEGITIMATUT
7. DATE OF 01 nTH
4.lYlIN. U.
I
I
c nal a 0
TRIPLZT. ml ORDER
Dcowfflior 12., 1912,9
OTH=R D I nTI-2
MOTHER
0 FULL
14. FULL
MAIDEN
Jacof int ", a I,
NAME ..,
0. RCSIDLINCZ
IV. RCSIDENCE
AT TIMZ OF
ATTIMEOF
txacr, Toxm.s
wl, 2;
THIS MInTH 4
THIS BIRTH
10. COLOR
AGE AT
10. COLOR
17. AGE AT
OR RACC
rilliz 07
OR RACE
I 11".) i to
TIMEOF
113
ito WrTH
THIS BIRTH YZAR9
12. DInTHPLACE
13. BIRTHPLACE
(ZTATZ OR
(OTATU OR 1, 0 " a s
COUN".Y)
COUNTnY)
C',
I:)A,.TRAOIZ. PnO-
IDA TRADE,PRO-
FEZ ION On KIND
o r
FESSION OR KIND
Ham- onw-fe
OF WORK OONr
I
a
--OF'vVCRK DONE
13 0. 1 N 0 U STRY 0.11
IDB.INDUSTRYOn
Z I
3US NESS IN WHICH
DUSINESS IN WHICH
ENGAG-ID
ENGAGED
20. NUMEBEn OF CHILDncu
21. NUMBER OF CHILDREN
UORN TO THIS PAOTHUR.
DORN TO THIS MOTHER,
INCLUDINGTHIS0111TH
AND NOW LIVING
E30RN ALIVE
I HER" .13Y CI:rTIFY TO r,-.= Zln-ia OF TH13 CHILD WHO WAS m AT—M. ON THE DATE STATED ABOVE.
STILLE30RN
nn. STGNATUr�v 'Juan Galindo Goli ad ma
ADDRESS Ton
AFFIDAVIT A
STATE OF TEXAS
Courla"ry OF
DEFORE ;A!: Q'il T RIC, DAY APPEA"Ir-:0
NNOINN TO ME TO D.2" TMr.:.' PERSON WHO SIGNED Tmu C211TIFICATL ATTACHED HERLIMO.' VJHO ON
OATH D=PO=S AND SAYS THAT THIZ FACTS STATED IN THE, FOREGOING BIRTH CtRTIFICATZ OF
ARE TRUE AND CORRECT TO THE 13EST OF
(NAUX Ar?ZAVt3WO ON CrATIFICATC)
H
HIS KNOWLED= AND 0ZLIZF, AIND 77-IAa- rj
'E.2.el -la-v WAS ACQUAINTED WITH THE FACTS AT THM TIME
OF Ti-lz,: EVE.NT.
Juan Galindo
55,
Sxd7OI`l",l TO NND '.-)Ur'SCP.I=.DZFORC ME. THIS r% AV r%7 --
By
7V
[SEAL] Caunty c2to":rl., 0TAnVPL3LIClIN AND rCR COUNTY. TEXA9.
A F F 1 0 A V I T
STATE OF T=XAS
COUNTY OF.
LVIO
;.) a,
BEFORE ME ON THIS DAY APPEAPEn
KNOWN TO VIE TO DO: THE PERC-ON VIHO SIGNE D THIS AFFIDAVIT WHO ON OAIIH _ffr_-F05ff-5_ 0 SAYS'.;
THAT THE FACTS STATED IN THE FORUGOING DIP'TH Cr-r-ZTIFICATd- OF
ARE TRUE AND COR'RECT TO THE 13E
(HAM9 APPtAKING ON Ct,%TiriCATZ) ST OF,�
KNOWLEDGE AND BELIEF, rom Tiqx� INTED WITH THE FACTS AND TIiAT!SHjE:,:J_Sp NOT
lir-Irl. SH 7Im ACQuA
RELATED TO THE INDIVIDUAL BY BLOOD OR MArlRIAGE.
L11126 11- Ybarbo
'o
SWORN TO AND SUDSCRIDED DZFORE ME. THIS 4th DAY OF, f�i voluallor 55
v Bernice Pettus
o"
tv
E Sr-_ A L I
f OTA I., %I -PU Z: C' I rl A rz 0 FO R —CounTy. T=.Ac.
T L A L',
3 7 A T u 0 F
cd,
Goliatl
TXU Mllririi CCRTIFICAT a 0.
NZ:,-_rC, WPZ CtJ=:ITT= TO T1412 COWIT, P-0 FOR IN H- 0- N'O. Ol4-40n., Laa.. FL 0. 1=0.
IT 13 7,4= 0,-D=? CF THIS COURT 7HAT %-:;Z T- IZ=GIgm%n rcj.rjLjr.,a IN -.qC' TA
.=CY THC STA T-
Ounmix C:f Vl'.TAL USTATiCTicc.
CIGONZ111" Linton S. Benge I CO. JUDau
Df,Tr 4 d
0 U NTY