Genealogy Research Request Form

PLEASE PRINT OR TYPE DATE:__________________________________

Name:

Address:

*Phone:

*E-mail:

$

Number of Total Amount for

Hours Authorized Research hours @

One Hour Minimum $10.00 each

Enclose $10.00 for each hour of research that you wish to authorize, with a one-hour minimum. Research will only be done with prepayment. You will be contacted with projected costs if the research time will exceed what you have authorized. Cost of all copies is 25¢ a page. Research is done within Portage County-includes libraries, historical society, and county offices, (**except land deeds). Requests for photos of tombstones require an extra charge.

Chapter volunteers do all the research and funds after expenses for copies are donated to the chapter.

**Research for land records-deeds-is a minimum of two hours.

Total Deed Research @ $20.00 for 2 hours

Cost of Copies @$2.00

Per page-Most deeds

are 2 pages

Total for Deed Research

There is a charge for postage unless a self addressed stamped envelope is included with enough postage to mail copies requested.

Nothing will be mailed in advance of payment.

If you send extra money it will be considered as a donation or will be returned if requested.

Estimated Cost

Number of Copies @25¢

Total Cost Copies

Postage

Total Amount Enclosed For All Research

Research Requested

Please ask short specific questions. Include as much detail as possible—include known dates, township, town, city or village, etc.

Tell us what you already have so we do not duplicate your research.

Continue on the back of the form if more room is needed or attach separate sheet

Surname(s) Limit of 2 names

*Please be sure to include a contact phone number or e-mail.

Office Use only: Check number_________________ Date Rec’d________________ Date Sent________________________