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Live-Life Claim 2021

The document appears to be a form for claiming knowledge of a live birth, with fields for the live birth name, date of birth, location of birth, parents' names, witnesses of the birth, and spaces for a picture, fingerprint, DNA sample, and autographs of the claimant and witnesses.

Uploaded by

Maurice Dyson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
12K views2 pages

Live-Life Claim 2021

The document appears to be a form for claiming knowledge of a live birth, with fields for the live birth name, date of birth, location of birth, parents' names, witnesses of the birth, and spaces for a picture, fingerprint, DNA sample, and autographs of the claimant and witnesses.

Uploaded by

Maurice Dyson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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:C.-S.-S.-C.-S.-L.

-FLAG OF THIS VESSEL

FOR THE CLAIMANT'S-KNOWLEDGE OF THIS LIVE-LIFE IS WITH THIS CLAIM BY


THIS CLAIMANT.

~1 FOR THIS CLAIMANT'S-KNOWLEDGE OF THIS LIVE-LIFE IS WITH THIS CLAIM


OF THE

1. LIVEBIRTH-NAME: ________________________________________, ON THIS

2. DATE-~___ DAY WITHIN THE MONTH-~_________ , IN THE YEAR-~ ____BY THESE


WITNESSES AND THIS CLAIMANT.

~2 FOR THIS CLAIMANT'S-KNOWLEDGE OF THIS LIVE-LIFE BIRTH IS WITH THE

3. LOCATION IN THE CITY-~ ________________ TERRITORY-~_________________

4. BY THE PARENTS: FATHER:____________________________________,

5. MOTHER:__________________________________

~3 FOR THESE WITNESSES OF THIS LIVE-LIFE BIRTH ARE , ON THIS DATE-~____


DAY

6.WITHIN THE MONTH-~____________ , IN THE YEAR-~ _____ WITH THE CLAIM OF

7.THE CLAIM OF THE LIVE-LIFE-DOCUMENT: ____________________________,


W Witness 1:______________________________,
Witness 2:______________________________,
Witness 3: _____________________________.

~4 FOR THIS PICTURE, FINGERPRINT-SEAL AND DNA-SAMPLE OF THIS


CLAIMANT ARE WITH THESE CLAIMS OF THIS FACTUAL-LIVE-LIFE BIRTH:

: PICTURE : : FINGERPRINT : : DNA-BLOOD/SALIVA :


:AUTOGRAPH-CLAIMANT-LIFEBIRTH
COPYRIGHT/COPY CLAIM: : _______________________

:AUTOGRAPH-WITNESS
COPYRIGHT/COPY CLAIM: : ________________________

:AUTOGRAPH-WITNESS
COPYRIGHT/COPY CLAIM: : ________________________

:AUTOGRAPH-WITNESS
COPYRIGHT/COPY CLAIM: : ________________________

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