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Get UDOH OVRS Form 14 2003

2b. COUNTY 3. BIRTHPLACE (State or Foreign Country) 4. DATE OF BIRTH (Month, Day, Year) 5. NUMBER OF THIS 6. IF NOT FIRST MARRIAGE, LAST MARRIAGE ENDED: MARRIAGE First, Second, etc. By Death, Divorce, Dissolution, Date (Mo., Day, Yr.) (Specify below) or Annulment (Specify Below) 7. RACE: White, Black, 8. EDUCATION: (Specify only highest grade completed) Amer. Indian, etc. Elementary/Secondary College (Specify below) 9a. WIFE'S NAME (First, Middle, Last) 9b. MAIDEN LAST NAME (0 - 12) 10.

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