![](https://www.pdfsearch.io/img/282c50b7b27a9d2cf72853f7692848d6.jpg) Date: 2014-09-02 23:05:50
| | Texas State Genealogical Society Mark with an X the name of the certificate you are applying for in the blank to the left. Fill in all blanks below. Begin with the applicant as number 1 in the line of descent. A check or
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