Important: Type or print in all blanks. More info on page 3.
Mail to:
Founding Families of Warren County
Senior Center
809 Morrison Street
McMinnville TN 37110
931-473-6559
Enclose a check or money order for $10.00 payable to: Founding Families of Warren County, TN
Check must accompany the application, the direct line of descent page, and the proof of descent page. (3 pages)
A. Applicant’s full name as it will appear on the certificate:__________________________________________________________________________
Street address, or PO Box ___________________________________________________
City, state, zip _____________________________________________________________
E-mail and phone number with area code _______________________________________
B. Name of Ancestor on the Warren County 1812 tax list, or 1808-1812 Grant or Deed
_______________________________________________________________________________
(Name of qualifying ancestor as name will appear on the certificate.)
Birth_______________________________ Death______________________________________
Date dd/mm/year Place Date dd/mm/year Place
Married ________________________________________________________________________
Date dd/mm/year Place Official and/or Bondsman
Spouse of Ancestor _______________________________________________________________
Given name and Surname/Maiden name
Birth______________________________ Death_______________________________________
Date dd/mm/year Place Date dd/mm/year Place
Residence_______________________________________________________________________
Not required, but if you know the district or area, please indicate.
Source of Proof for Ancestor_______________________________________________________
Warren County 1812 tax list, or 1808-1812 Grant or Deed