Research Request Form               

One inquiry per letter

 

Juniper Branch of Family Finders

21 SE “D” Street

Madras, OR 97741

jbff@madras.net

 

 

Your Name: _______________________________________Date_____________

Your Address: Street_________________________________________________

City___________________________State_________Zip___________

Phone Number:__________________ Email_______________________________

 

Name of Person or Subject of your inquiry_________________________________

 

Spouses Name________________________________________________________

 

Dates of residence or occurrence in Jefferson County (approx. if exact date unknown)

_________________________________________

 

 

Place of occurrence or individuals residence: ie, town, county, other __________________

_____________________________________________________________________

 

Exact (or approx) year of birth ____________________ year of death _______________

 

Please state briefly what information you need: __________________________________

_____________________________________________________________________

_____________________________________________________________________

 

Cite any sources you have already checked and include references: _____________________________________________________________________

_____________________________________________________________________ _____________________________________________________________________