Patriot Graves Report

Posted Tue, 2010-02-09 13:27 by webmaster

Form Description:

This Form, and the Data on this form, are for Committee use Only.
To submit a registration electronically using this form:
(1) Follow the instructions to enter the requested information
(2) When form is complete click "Register" at the bottom of the form.

Note: You may print this page out, fill it in by hand and mail this form to:
Revolutionary War Graves Committee, NSSAR
1000 South Fourth St.,
Louisville, KY 40203

This is a webform. A form that is filled out on the website. The data will be forwarded to the parties that need it.

Patriot Information

These fields are for the information about the Patriot

Prefix:

Patriots First Name:

Patriots Middle Name:

Provide the Patriot's middle name

Patriots Family Name (Last Name): *

Provide the Patriots Family or Last Name. Include alternate spellings in brackets i.e Towler (Toler) (Toller)

Suffix:

Birth Date:

Birth Place:

If known, provide the birth place of the Patriot

Death Date:

Death Place:

If Known, please provide the Location of death

Service Information

Details for the Patriot's service

State of Service:

Service Details:

Please provide the details of the service (Unit, office, Commanders, etc.)

Service Reference:

Provide the reference for the service details

Pension Number:

Burial Information

Burial Details

Cemetery Name:

Cemetery Location Town:

Please provide the name of the City, Town or Township that the Cemetery is located in.

Cemetery Location County:

Please provide the County the Cemetery is located in.

Cemetery Location State:

Please provide the State that the Cemetery is located in

GPS Latitude:

If known, please provide the GPS Latitude for the grave.

GPS Longitude:

Cemetery Notes:

If special Directions for Locating Cemetery and Grave site are needed, or other info, please provide it here.

Marker & Tombstone

Tombstone:

Yes

Is there a tombstone / Headstone at the site

Other Information:

If you have any other information about the burial please provide it here.

Spouse Information

Spouse 1 Full Name:

Please provide the full Birth name of the First Spouse

Spouse 1 Pension:

If Spouse 1 had a Pension, please provide the pension number

Spouse 2 Full Name:

Please provide the full Birth name of the Second Spouse

Spouse 2 Pension:

If Spouse 2 had a Pension, please provide the pension number

Spouse 3 Full Name:

Please provide the full Birth name of the third Spouse

Spouse 3 Pension:

If Spouse 3 had a Pension, please provide the pension number

Submitters Information

Tell us about yourself

Submitters Name: *

Submitters Email: *

Submission Date: *

NSSAR Publication Classification:
- NSSAR Webform,
- NSSAR Form