Request to Search for a Name on NSSAR Applications
Form Version: 98Jan17
Print or type your name: ________________________________________ Date:__________
To print this page use the print icon at the top of your browser. Use a separate form
for each request.
Print or type the following:
Full name of the ancestor: _______________________________________________
Note: Give all known data for the ancestor and list any variant spellings for the
Date and state of birth: ______________ Date and state of death: ________________
State in which he served or resided: __________________________________
Name(s) of wife (wives): __________________________________________________
Name of their child through whom the lineage is being traced: _______________________
NOTE:If at all possible specify the name of the ancestor's child through whom you are
descended, since this may help us identify which of several descendency lines is yours.
. . . . Will you accept a line traced through another child? Circle . YES . or . NO
Be sure you have included your check for $5 for each name requested.
See the instruction sheet for further information.
Print or type your mailing address in the lines below.
National Society SAR
1000 South Fourth Street
Louisville, KY 40203