1. ENTRY FORM
(FOR INDIVIDUAL ORDINANCES)
Name {Per SQn to receive n ofificoti cn] - Sta ke ai' Mission
Bertha S era un Bellevue Washington
Ward Examin r Ward Examiner
Address 16611 S. E. 8 th
C43 '
Bellevue, WA 98008 Please reserve q,l!.alifyinil names in thJ family file at the
Seot+le
Temple
for ~ Baptism ~ Endowment Sealing
Race
Perez Mex
6 Birthplace (parish or town, covnty, ,tote or counlry) 7 Birth date (day, month, year)
abt 1825
8 Christening place (pcr:,h, county, state Of country) 9 Christening date (day, month, year)
Augualeguas, Nuevo Leon, Mexi co
10 Father's given name (s) 11 Father's surname (s) 12 Death or burial date of 3 above (cluy, month, yeer)
Luciano Garza
13 Mother's given name (s) 14 Mother's surname (s) 3 16 LOS baptism date
e Pere LG
Father's residence Father's title or occupation 18 Date sealed to parents
19
6 Birthplace (parish or town, county, stote or country) 7 Birth date (cley, month, year)
II.. V
abt 1850
'. 8 Christening place (perish, covnry, stale or country) 9 Christening date (day, month, vecr )
,10 Father's given name (s) 11 Father's surname (s) 12 Death or burial date of 3 above (day, month, ve cr )
13 Mother's given name (s) 14 15 Your relationship t 16 LOS baptism date
Fernina Gonzales s-g -g -do u (sea led)
Father's residence Father's title or occupation 17 Endowment date 18 Date sealed to parents
19
Antonio Vicente Ferrer Salinas
6 Birthplace (parish or rown, county, stale country) 7 Birth date (day, month, year)
r_'. II. V.
abt 1792
8 Christening place (pm,sh, county, or country) 9 Christening date (day, month, year)
10 Father's given name (s) 11 Father's surname (s) 12 Death or burial date of 3 above (doy, month, year)
Juoquin Salinas
13 Mother's given name (s) 14 Mother's surname (s) 15 Your relationship to 3 16 LDS baptism date
Ma dalena Pe na
Father's residence Father's title or occupation Date sealed to parents
19 Source of information FDD
same as above
MDD
I was sealed to them in the Logan Temple 18 Feb. 1925·
PFGS009-5 1/73 SOOM PRINTED IN USA BY PUBLISHERS PRESS (FDD-father's death date; MDD-mother's death date)
![ENTRY FORM
(FOR INDIVIDUAL ORDINANCES)
Name {Per SQn to receive n ofificoti cn] - Sta ke ai' Mission
Bertha S era un Bellevue Washington
Ward Examin r Ward Examiner
Address 16611 S. E. 8 th
C43 '
Bellevue, WA 98008 Please reserve q,l!.alifyinil names in thJ family file at the
Seot+le
Temple
for ~ Baptism ~ Endowment Sealing
Race
Perez Mex
6 Birthplace (parish or town, covnty, ,tote or counlry) 7 Birth date (day, month, year)
abt 1825
8 Christening place (pcr:,h, county, state Of country) 9 Christening date (day, month, year)
Augualeguas, Nuevo Leon, Mexi co
10 Father's given name (s) 11 Father's surname (s) 12 Death or burial date of 3 above (cluy, month, yeer)
Luciano Garza
13 Mother's given name (s) 14 Mother's surname (s) 3 16 LOS baptism date
e Pere LG
Father's residence Father's title or occupation 18 Date sealed to parents
19
6 Birthplace (parish or town, county, stote or country) 7 Birth date (cley, month, year)
II.. V
abt 1850
'. 8 Christening place (perish, covnry, stale or country) 9 Christening date (day, month, vecr )
,10 Father's given name (s) 11 Father's surname (s) 12 Death or burial date of 3 above (day, month, ve cr )
13 Mother's given name (s) 14 15 Your relationship t 16 LOS baptism date
Fernina Gonzales s-g -g -do u (sea led)
Father's residence Father's title or occupation 17 Endowment date 18 Date sealed to parents
19
Antonio Vicente Ferrer Salinas
6 Birthplace (parish or rown, county, stale country) 7 Birth date (day, month, year)
r_'. II. V.
abt 1792
8 Christening place (pm,sh, county, or country) 9 Christening date (day, month, year)
10 Father's given name (s) 11 Father's surname (s) 12 Death or burial date of 3 above (doy, month, year)
Juoquin Salinas
13 Mother's given name (s) 14 Mother's surname (s) 15 Your relationship to 3 16 LDS baptism date
Ma dalena Pe na
Father's residence Father's title or occupation Date sealed to parents
19 Source of information FDD
same as above
MDD
I was sealed to them in the Logan Temple 18 Feb. 1925·
PFGS009-5 1/73 SOOM PRINTED IN USA BY PUBLISHERS PRESS (FDD-father's death date; MDD-mother's death date)](https://image.slidesharecdn.com/scandoc0004-121222145415-phpapp02/85/Scan-doc0004-1-320.jpg)
