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Record Raquest FD-125 (Rev. 1-30-75) 3D 5 IL O0GS Dute \ iL3 Death (_J INS [ ] Marriage + KG soroe Vehicle AT Other Ube, bd Oriver’s License , (J Birth £_] Credit To File number —_ ey 2 ye 9 6 Retum to »! r Name and aljases of subject, epplicent, or empleyee, and spouse Addresses Residence Business Forver * Date and place of marriage (if applicable} NC, flace Co “ Birth date Birthplace b7c Atrest Number Eyes Fingerpnnt classification Criminal specialty Specific information desired sucial Security Number Reaults of check i \ OCT 2 1995 |