Please copy the form and paste it into a word document. Print, fill out and mail your query to DCGS where your query will be investigated.
INSTRUCTIONS: Decide which ancestor or relative you want to be the subject of your query. Fill in every blank that you can. He/She should have lived in Dade Co., MO during at least part of their life. Place names of parents, spouse(s), siblings and children in the spaces provided,. If you do not know a name, date or place, don’t worry about it. Put a question mark in front of information that is speculation. Put ca. in front of dates that are estimates. If you want to include more information about a parent, sibling or child, fill out a separate form for them.
YOUR NAME: ___________________ MEMBER: YES: _____ NO: _____
CITY: _________________ STATE: ___________ ZIP+4: _____________
Seeking info about __________________, born _________________
(Subjects Name) (d/m/y)
in _______________________; died ____________ in __________________.
(Location) (d/m/y) (Location)
Child of ______________________, (________________________________) and
(Father’s Name) (Father’s bth. & dth. Yrs.)
(Mother’s name & maiden name) (Mother’s bth. & dth. Yrs.)
Subject married on ____________________, in ________________________
to ______________________________, born on _______________________
(Spouse’s name) (d/m/y)
in ______________________________; died __________________________