State of Tennessee
Department of Public Health
Name at birth: Georgia Ellen Eaker
Date of birth: Sept. 24, 1890
birthplace: McNairy Rural
father: Christopher Columbus Eaker,
mother: Tempia Elizabeth Hendrix,
I hereby certify, on oath, that the above statements are
true. (To be signed by parent or legal guardian if
registrant is under 12 years of age.)
Signature of registrant: Georgia Eaker Hurley
present address: Chewalla, Tennessee
subscribed and sworn to before me on June 3, 1953
Abstract of supporting evidence:
1. Facts of birth established by McNairy Court order on
July 8, 1953.
2. Affidavit of Aunt, Fannie Derryberry
on June 29, 1953.
3. Affidavit of non-relative, T.A. Ledbetter
on June 29, 1953
4. Copy of court order on file with state registrar,
File no. C-10297
Issued August 3, 1953.