PRIVATE FAMILY-HISTORY RECORD
Keep the completed worksheet with you. Do not send personal documents through a public website.

Research question:
Person / photograph / place:
Name and place-name variants:
Time (exact or approximate):

What is known:
How it is known (storyteller / document):
Conversation or document date:
Page / archive reference / link:
What remains unconfirmed:

Permission to record and who may see it:
What must not be published:
Next source or question: