REQUEST FORM

Please print this page out and then fill in the information you are looking for. If you would prefer to just send an email containing all the information and request an estimate that is fine too.  Or you may send the form along with your money order to: 

Let Leo Look

101 Clement Avenue

West Roxbury, MA 02132

Name of Person Whose History is to be researched:

In which country to search:

First Name:

Last Name:

Birth Day:

Birth Month:

Birth Year:

If unknown Birth Date enter Approximate Date:

Birth Place:

Fathers Name:

Mothers Name:

Name of Spouse:

Marriage Date:

Marriage Place

Death Date:

Death Place:

Religion:

Race:

Occupation:

Military Service:

Names of Siblings:

Briefly Explain what information you are seeking:

Please add any additional comments (Nicknames, etc. - use additional sheet if necessary):

List Certificates you are seeking for from me:

Tell me something about yourself so I can get the information returned to you.

Your First Name:

Your Last Name:

Address:

City:

State:

Zip:

Telephone:

E-mail address:

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If you cannot print this Request form

please send me an email and I will send you the form.