Ancestor's Name ____________________________________________
Approximate Date of Birth ____________________________________
Place of Birth (Parish/Townland) _______________________________
Father's Name ______________________________________________
Mother's Name _____________________________________________
Names of Siblings ___________________________________________
Did Ancestor Marry in Ireland ? ________________________________
If so, Where/When ? _________________________________________
Name of Husband/Wife _______________________________________
Names of Children born in Ireland ______________________________
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Date of Emmigration _________________________________________
Did Parents Emigrate ? _______________________________________
Any other Information ________________________________________
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