CA1408

Earl Francis Hines birth record at wvculture.org (West Virginia Department of Arts, Culture and History)
(C. Avis Catalog entry #1408)

https://archive.wvculture.org/vrr/va_view2.aspx?FilmNumber=004017253&ImageNumber=1098

WEST VIRGINIA STATE DEPARTMENT OF HEALTH
DIVISION OF VITAL STATISTICS - CHARLESTON

DELAYED CERTIFICATE OF BIRTH

5281

Full name at birth    Earl Francis Hines
Date of birth            7  16  1900
Color or race           White
Sex                          Male
Birthplace                Webster Springs, Webster County, W VA
Father                      Ballard Jackson Hines
Birthplace                Webster Co., W. VA
Mother                     Amanda Eveyln Clifton
Birthplace                Webster Co., W. VA

    I hereby declare upon oath that the above statements are true to the best of my knowledge and belief.  (To be signed if possible by the person whose birth is to be registered.)

Signature         Earl Francis Hines             Address         R7012 Smithfield PO

Subscribed and sworn before me on    Sept 5 1959    Goldie V. Cooley  Exp 2-13-62

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Abstract of Supporting Evidence
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1. Affidavit of Mother, Amanda Evelyn Hines, Age 74 yrs.    Sep. 5, 1959
2. Birth Certificate of Applicant's child, W. Va.,, D.V.S. #20288 - July 17, 1923
3. Prudential Life Ins. Co. of America, Newark, N. J., Pol. #393035145 - July 24, 1939

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Information Concerning Registrant as Stated in Document
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Birth Date or Age                  Birthplace                          Name of Father                  Full Name of Mother

1. July 16, 1900                    Webster Springs, W.Va.    Ballard Jackson Hines        Amanda Evelyn Clifton
2. Age 23 yrs. LB**
3. July 16, 1900                     West Virginia


Additional Information:  *3  original;    *2   **(last birthday)

Abstractor     Elizabeth Ashley        Date:    Oct. 6, 1959

Statement of Reviewing Official
I hereby certify that I have reviewed the evidence recorded above and that the information contained therein is as noted in the preceding abstract and there was no previous registration found for this person in the Division of Vital Statistics.

Signature:       A. Faye Owen   Reviewing Official             Date filed    Oct. 6, 1959