In support of this application, I provide the following data, supported by the enclosed documentation, and request that
you prepare a formal Application for my review and signature, and for approval by the Registrar-General; and later
presentation to the Board of Governors for acceptance into the Society. I also enclose my check to cover the
Application Fee and the selected dues level.
Street, R.F.D. or P.O. Box:
Having Living or deceased children by bloodline of applicant and not by adoption, by my spouse
(Give all full names, dates, and places known. Show dates as day, month, year, e.g. 18 Sep 1902)
REFERENCES: Documentation is required for each statement of an event [birth, marriage, death],
in each of the numbered generations you are reporting. This Worksheet Application has only 5 of
the more recent generations for you to complete - that generally should be enough. If it is not, i.e.
you need more, add the data and the documentation for the additional generations back to you on
a separate sheet of paper. Conversely, you may only need 2, 3, or 4 of the generations to get back
to a fully referenced generation removed from your signer in “Pyne’s Register” - then do not use the
remaining spaces. All the documentation must contain data that supports the statement of the event.
Certificates are fine, Federal Census Schedules for and after 1850 (that name all the members of
a household), title pages and the pertinent pages of authoritive and properly referenced compiled
genealogies; DAR and SAR Record Copies of the more recent applications are also good support.
Note that the space for you on this “Worksheet” to report anything much beyond mere notice of the
type of documentation being submitted is purposefully not large. This is because you are expected
to include, as a part of your application, a Summary of Proofs - a more complete and detailed
explanation of the proofs you are providing in support of this application.
I enclose the following references, and a Summary of Proofs, from myself back
through the generation from me, numbered by generation in support of this Application. I
understand that the Registrar-General will be able to extract data from The Genealogical Register
of the Descendants of the Signers of the Declaration of Independence, (Picton Press, 1998 - 2002)
to add data for the older generations back to my signer, and thus prepare a full and complete formal
Application for approval, and presentation to the Board of Governors for acceptance.
My Gen. (Birth Certificate must name parents)
From this 5th Generation on back to my signer ancestor
in the generation, data from The Genealogical Register of the Descendants of the Declaration of Independence, (Picton Press), Volume will be copied by the Registrar-General onto my formal Application for membership. Data I have furnished, and included on this Worksheet; will also be copied onto that formal Application. Thus a full, documented formal Application (in two copies) will be prepared, submitted to me for review and signature, returned, for approval, and presented by
the Registrar-General to the Board of Governors of the Descendants of the Signers of the Declaration of Independence (DSDI)for their acceptance of my admission into the Society.