Person Requesting Information

First

Last

Suffix

Mailing Address

Address

Address 2

City/Town

State/Province

- None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

ZIP/Postal Code

Daytime Phone

Email

Reason for the Request

Information for Whom:

Name

First

Middle

Last

Suffix

Date of birth

City to be searched

Parish to be searched

Search Baptismal Record?

Yes

No

Search Confirmation Records?

Yes

No

Search First Communion Record?

Yes

No

Search Marriage Record

Yes

No

Bride’s First and Maiden Name

First

Last

Grooms First and Last Name

First

Last

Suffix

Approximate Date of Marriage

City of Marriage

Parish of Marriage

Search Death Records?

Yes

No

Deceased’s First and Last Name

Title

Title

- None -MissMsMrMrsDrOther…

Enter other…

First

Middle

Last

Suffix

Degree

Approximate Date of Death

City of Death

Parish of Funeral

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