(Attachment to Family History Chart

Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5

Family History Form 2011

Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5

OMB: 1076-0160

Document [doc]
Download: doc | pdf

OMB Control # 1076-0160

Expiration Date:XX/XX/XXXX

Family History Chart

For Categories B, C & D







(IV) Great-grandfather

BD:_____________

Tribe:

(III) Grandfather


BD:_____________


Tribe:

(IV) Great-grandmother

BD:_____________

Tribe:

(II) Father


BD:_____________


Tribe:


(IV) Great-grandfather

BD:_____________

Tribe:

(III) Grandmother


BD:_____________


Tribe:

(IV) Great-grandmother

BD:_____________

Tribe:

(I) Applicant


BD:_____________ DOB:_____________


Tribe:

(IV) Great-grandfather

BD:_____________

Tribe:

(III) Grandfather


BD:_____________


Tribe:

(IV) Great-grandmother

BD:_____________

Tribe:

(II) Mother


BD:_____________


Tribe:

(IV) Great-grandfather

BD:_____________

Tribe:

(III) Grandmother


BD:_____________


Tribe:

(IV) Great-grandmother

BD:_____________

Tribe:


File Typeapplication/msword
File TitleGreat-great-great-great-grandfather
AuthorDaisy West
Last Modified Byelizabeth.appel
File Modified2011-08-09
File Created2011-08-09

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