1. Healthcare

Certificate # 2015 -­‐ ______________ New Mexico Genealogical Society
Founded 1960
A NON PROFIT CORPORATION
P.O. BOX 27559, ALBUQUERQUE, NEW MEXICO 87125-7559
___________________________________________________________________________________ APPLICATION PRIMERAS FAMILIAS de NUEVO MÉXICO Full Name of Certificate Applicant ______________________________________________________________________ Descendant of: ____________________________________________________________________________________________ Full name of earliest ancestor on this application Please print or type. For Documentation instructions, see “Proof of Eligibility” on page 4. Surnames: Use name given at birth. Localities: include city, county, state, county and country. 1) Certificate Applicant was born on: ______________________________________________________at_____________________________________________________ Married to:________________________________________________________________________________________________ on___________________________________________________at_____________________________________________________ Documentation ___________________________________________________________________________________________ _____________________________________________________________________________________________________________ 2) Said (1) is son/daughter of_____________________________________________________________________________ Born on ____________________________________________at_____________________________________________________ Died on _____________________________________________at_____________________________________________________ AND (1st/2nd/3rd) Wife/Husband Name_________________________________________________________________ Born on _____________________________________________at_____________________________________________________ Married on__________________________________________at_____________________________________________________ Documentation____________________________________________________________________________________________ ______________________________________________________________________________________________________________ 3) The Said (2) was child of _________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Died on______________________________________________at_____________________________________________________ And (1st / 2nd / 3rd Spouse ________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Married on__________________________________________at_____________________________________________________ Documentation_____________________________________________________________________________________________
_______________________________________________________________________________________________________________ Page 1 of 4 Certificate # 2015 -­‐ ______________ 4) The Said (3) was child of _________________________________________________________________________________ Born on____________________________________________at______________________________________________________ Died on_____________________________________________at______________________________________________________ And (1st / 2nd / 3rd Spouse )_______________________________________________________________________________ Born on____________________________________________at_______________________________________________________ Married on________________________________________at_______________________________________________________ Documentation_____________________________________________________________________________________________
______________________________________________________________________________________________________________ 5) The Said (4) was child of _________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Died on______________________________________________at_____________________________________________________ And (1st / 2nd / 3rd Spouse ________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Married on__________________________________________at_____________________________________________________ Documentation_____________________________________________________________________________________________
_______________________________________________________________________________________________________________ 6) The Said (5) was child of __________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Died on______________________________________________at_____________________________________________________ And (1st / 2nd / 3rd Spouse ________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Married on__________________________________________at_____________________________________________________ Documentation_____________________________________________________________________________________________
______________________________________________________________________________________________________________ 7) The Said (6) was child of _________________________________________________________________________________ Born on____________________________________________at______________________________________________________ Died on_____________________________________________at_____________________________________________________ And (1st / 2nd / 3rd Spouse )______________________________________________________________________________ Born on____________________________________________at______________________________________________________ Married on________________________________________at______________________________________________________ Documentation_____________________________________________________________________________________________
______________________________________________________________________________________________________________ 8) The Said (7) was child of _________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Died on______________________________________________at_____________________________________________________ And (1st / 2nd / 3rd Spouse ________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Page 2 of 4 Certificate # 2015 -­‐ ______________ Married on__________________________________________at_____________________________________________________ Documentation_____________________________________________________________________________________________
______________________________________________________________________________________________________________ 9) The Said (8) was child of __________________________________________________________________________________ Born on____________________________________________at_______________________________________________________ Died on_____________________________________________at______________________________________________________ And (1st / 2nd / 3rd Spouse )_______________________________________________________________________________ Born on____________________________________________at_______________________________________________________ Married on________________________________________at_______________________________________________________ Documentation_____________________________________________________________________________________________
______________________________________________________________________________________________________________ 10) The Said (9) was child of __________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Died on______________________________________________at_____________________________________________________ And (1st / 2nd / 3rd Spouse ________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Married on__________________________________________at_____________________________________________________ Documentation_____________________________________________________________________________________________
______________________________________________________________________________________________________________ 11) The Said (10) was child of ________________________________________________________________________________ Born on______________________________________________at____________________________________________________ Died on______________________________________________at_____________________________________________________ And (1st / 2nd / 3rd Spouse ________________________________________________________________________________ Born on______________________________________________at_____________________________________________________ Married on__________________________________________at_____________________________________________________ Documentation_____________________________________________________________________________________________
_______________________________________________________________________________________________________________ 12) The Said (11) was child of ________________________________________________________________________________ Born on____________________________________________at_______________________________________________________ Died on_____________________________________________at_______________________________________________________ And (1st / 2nd / 3rd Spouse )________________________________________________________________________________ Born on____________________________________________at_______________________________________________________ Married on________________________________________at_______________________________________________________ Documentation_____________________________________________________________________________________________
______________________________________________________________________________________________________________ Page 3 of 4 Certificate # 2015 -­‐ ______________ PROOF OF ELIGIBILITY: For each generation, list the authoritative reference for EACH statement of birth, marriage, and death listed. If you have no proof, leave the space blank. Proofs may include: Photocopies of birth, marriage, and death certificates Copies of printed material, including title page of reference book and applicable page of book i.e. Santa Cruz Baptismals and Marriages Title Page, page 220 and photocopies of those pages. Photocopies of Bible records, with the title page of the Bible Courthouse records, including copies of the book face page, page with page number Copies of all the proofs MUST accompany your application. Retain the originals of all materials submitted, as the application and copied documents become the property of the New Mexico Genealogical Society. It is important that proofs be included that link each generation to the next. It is permissible to go from the male in one generation to the female in the next dependant on the surname you are researching. The Primeras Familias de Nuevo Mexico committee will review all applications received. It is the committee’s responsibility to make the final decision as to acceptance or rejection of each application. FEES: NMGS Members $40.00 for each surname application $20.00 for each additional certificate for a different descendant with the same lineage. Non-­‐members $50.00 for each surname application and $20.00 for additional certificate for different descendant with same lineage. Make check payable to New Mexico Genealogical Society and mail to P.O. Box 27559, Albuquerque, New Mexico 87125-­‐7559, to the attention of PRIMERAS FAMILIAS. PUBLICATION AND USAGE RELEASE Please Initial Yes No Notice of Certificate Award to Descendant and Lineage may be published in the New Mexico Genealogist Journal (dates for living descendants are never published) _______ _______ Lineage and Primeras Familias confirmation may be utilized as a resource by the New Mexico Genealogical Society and its publications _______ ________ VITAL RECORDS ARE NEVER RELEASED OR SHARED. CERTIFICATE PERIOD APPLIED FOR: Native American _________ Oñate 1598–1680 _______ Reconquest 1692-­‐1821 _______ Mexican Period 1821 – 1846 __________ Territorial Period 1846 – 1912 ___________ SUBMITTED BY: _____________________________________________________ Date: _____________________________ Mailing Address: _________________________________________________________________________________________ ______________________________________________________________________________________________________________ Email: ______________________________________________________________Phone: _____________________________ Page 4 of 4