Roster Form
Arkansas Ancestor #: ______________
Revolutionary Ancestor:
____________________________ ____________________________ _____________________________
First
Middle
Last
State from which Patriot served: _______________________ Service: ________________________________________________
Ancestor Born:
Ancestor Died:
_______________________ ______________________________________________________________________
date
place
________________________ _______________________________________________________________________
date
place
Married: (1) ______________________________________ at _____________________________ date ___________________
(2) ______________________________________ at _____________________________ date ___________________
(3) ______________________________________ at _____________________________ date ___________________
Children of Revolutionary Ancestor (by each marriage):
Name:
Born:
To whom Married (Note if married more than once):
________________________________________
__________________
________________________________________
________________________________________
__________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
USE THE REVERSE SIDE FOR ADDITIONAL CHILDREN - Revised 2014
Roster Form
Arkansas Ancestor #: ______________
Revolutionary Ancestor:
____________________________ ____________________________ _____________________________
First
Middle
Last
State from which Patriot served: _______________________ Service: ________________________________________________
Ancestor Born:
Ancestor Died:
_______________________ ______________________________________________________________________
date
place
________________________ _______________________________________________________________________
date
place
Married: (1) ______________________________________ at _____________________________ date ___________________
(2) ______________________________________ at _____________________________ date ___________________
(3) ______________________________________ at _____________________________ date ___________________
Children of Revolutionary Ancestor (by each marriage):
Name:
Born:
To whom Married (Note if married more than once):
________________________________________
__________________
________________________________________
________________________________________
__________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
________________________________________
___________________
________________________________________
USE THE REVERSE SIDE FOR ADDITIONAL CHILDREN - Revised 2014