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" ... [Signature of father, mother, or guardian]. [Town or city and date]. There personally appeared before me the above named [name of person signing] and made oath that the foregoing certificate by [him or her] signed is true to the best of [his or her]... "
Annual Report of the Department of Inspection of Workshops, Factories and ... - Halaman 233
oleh Ohio. Department of Inspection of Workshops, Factories and Public Buildings - 1889
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Public Documents of Massachusetts, Volume 11

Massachusetts - 1898
...guardian or custodian] of [name of child] , and that [he or she] was born at [name of town or city] , in the county of [name of county, If known] , and state [or country] of , on the [day and year of birth] , and Is now [number of years and months] old. (Signature of &ther,...
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Public Documents of Massachusetts, Volume 8,Bagian 1

Massachusetts - 1896
...[father, mother or guardian] of ^mma of chM^ and that ("he or she-| was born at [name of town or city], in the county of [name of county, if known], and state...birth], and is now [number .of years and months] old. Then personally appeared before me the above named [name of person signing] and made oath that the...
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Report of the Commissioner of Education Made to the Secretary of ..., Volume 1

United States. Bureau of Education - 1906
...guardian, or custodian] of [name of minor] , and that [he or she] was born at [name of city or town] , In the county of [name of county, If known] , and state [or country] of , on the [day and year of birth] , and is now [number of years and months] old. (Signature of father,...
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Annual Report, Volume 1

United States. Office of Education - 1906
...guardian, or custodian] of [name of minor] . , and that [he or she] was born at [name of city or town] , in the county of [name of county, if known] , and state [or country] of , on the [day and year of birth] , and Is now [number of years and months] old. (Signature of father,...
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Report of the Commissioner of Education Made to the ..., Volume 1,Bagian 1-2

United States. Bureau of Education - 1891
...[father, mother, or guardian] of [name of child), und that [ho or she] was born at [name of town or city], in the county of [name of county, if known], and State [or county] of [name], on the [day and year of birth J, and is now [number of years mid months] old. [Signature...
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The Public Statutes of Massachusetts Relating to Public Instruction ... 1888

Massachusetts - 1888 - 90 halaman
...[father, mother or guardian] of [name of child], and that [he or she] was born at [name of town or city], in the county of [name of county, if known], and state...months] old. [Signature of father, mother or guardian.] Then personally appeared before me the above named [name of person signing] and made oath that the...
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Annual Report of the Bureau of Industrial and Labor Statistics for the State ...

Maine. Bureau of Industrial and Labor Statistics - 1889
...[father, mother or guardian] of [name of child], and that [lie or she] was born at [name of town or city], in the county of [name of county, if known] and state...country] of [name], on the [day and year of birth,] and 1s now [number of years and months] old. [Signature of father, mother or guardian.] [Town or city and...
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Biennial Report

Minnesota. Department of Labor and Industry - 1890
...mother, or guardian] of [name of child, 1 and that [he or she] was born at [name of town or city,] in the, county of [name of county, if known,] and state [or country] of [name,] on the [day and yearof birth, jandisnow [number of years and months] old. [Signature of father, mother, or guardian.]...
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Congressional Serial Set

1892
...[he or she] was born at [name of town or city], in the county of [nameof county, if known,] and s^ate [or country] of [name], on the [day and year of birth], and is now [number*of years and months] old. [Signature of father, mother 9r guardian.] [Town or city and date.]...
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Annual Report of the Commissioner of Labor, Volume 8

United States. Bureau of Labor - 1892
...or she] was born at [name of town or city], in the county of [name of county, if known,] and s^ate [or country] of [name], on the [day and year of birth], and is now [numbef^of years and months] old. [Signature of father, mother or guardian.] [Town or city and date.]...
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