COUNTY OF WHARTON Uae oF texas CERTIFICATE OF BIRTH nH No. TAREE OF BAT EUSIAL REOENCE OF HOTA We Sema “5 COUNTY Taarton as Poxas scomm Wharton Tt Ree TTY OR TOWN Wailea Tas gr ped] ampo, Texas: rr GABDO Deas = S TEST aa aoe Perkins Jr.|_3- 19- oO =e Yes: eer IF CoLROR Pericins Colored Te USUAL OCCUPATION a RR Ce HENES OR ROUTAY | Laborer iar Rice Fields Re —— a Tia coor Jeannette Hochelle Hodeon Colored S| aee een —— Ye BRERA Ge om cr TCH HENGE TTS THE NOM NOT ee mer California Soman ee [ermoreiome | diyidauneenes ST = Siar Jeannette 2ochelle Hodson Perkins i 9 2 po TisanTS SeIOTIAE ae ATDTATERT sia We 5. Triltgen, M. D. wo. 20.9 wowep one ol Re ATROARTS PRES Tie onTEeSCNED 3316 Ae Ul Campo, Texas March 19, 1959 April 2, 1959 ---— _|Joe Sears Local Registringe Ree ISSUED UNGEn AlTHORTY OF SECTION 101.061 NEATH AN SAFETY CODE. NNN: REPOROAS RECORDED N TAS OFFICE socom fh 20 20 Maeda k birdie ‘toga sere. coy CLEWharton, TX Sandra K. Sanders County Clerk P.O. Box 69 Wharton, TX 77488 Phone Number : (979) 532-2381 Fax Number: (979) 532-8426 Official Receipt : 2014-00002635 Printed On : 04/28/2014 _at_2:30:34 PM By:38 on INDEX4 Customer : THELTON PERKINS Date Recorded : April 28, 2014 Instrument ID Recorded Time ‘Amount 2:30:03 PM $23.00 Transaction : Birth Certificate Accounts Amount Birth Certificate Fee (Bo) $10.20 Vit Stats Search Fee (Vssf) $10.00 Surcharge Birth Cert St(Sbes)* $1.80 Vit Stats Presv Fd-Cc (Vpres) $1.00 Itemized Check Listing Check Number : 6925168198 $23.00 Total Due $23.00 Paid by Check $23.00 Change Tendered : $0.00 HAVE ANICE DAY! Page foft10 a 2 13 14 15, 16 v7 18 19 20 21 2 23 24 25 26 7 28 29 AFFIDAVIT OF FACT AND TRUTH PURSUANT TO CHXIV, State of September 15, 1789, 1 Stat. 68-69; 22 United States Code (USC) 2657; 22 USC 2651a; 5 USC 301; 28 USC 1733 et. seq.; 8 USC 1443(f); RULE 44 Federal Rules of Civil Procedure AND PURSUANT TO MINNESOTA COURT RULES GENERAL RULES OF PRACTICE - Rule 220 Birth Certificates: “The Registrar of Titles is authorized to receive for registration of memorials upon any outstanding certificate of ttk the party named age of the majority at a date 18 years after the date of birth shown by said certificate, | birth certificate pertaining to a registered owner named in said certificat title showing the date of birth of said registered owner, providing there is attached to said birth certificate an affidavit of an affiant who states that he/she is familiar with the facts recited, stating that said birth certificate is the same party as one of the owners named in said certificate of title; and that thereafter the Registrar of Titles shall treat said registered owner as having attained the 1991 Adoption “This rule is derived from 4th Dist. R. 11.05” The undersigned affiant Thelton-Ray-Junior: Perki follows: ‘+ Affiant is competent to state the matters set forth herein © _Affiant is of the age of majority or greater that eighteen (18) years of age * Affiant has knowledge of the facts stated herein does solemnly affirm, declare, and state as + Allthe facts herein are true, correct and complete, admissible as evidence and if called upon as a witness, affiant will testify o their veracity. Statement of Facts: ‘The attached document is a “TRUE AND CORRECT REPRODUCTION" of the original the CERTIFICATE OF LIVE BIRTH for THELTON RAY PERKINS JR.., printed on April 28, 2014 AT 2. 3038 a by:38 ON index4 and is preserved under Registrar's file number 21, certificate of birth number 46239, and official receipt number 2014-00002635 in COUNTY OF WHARTON, TEXAS; CITY OF WHARTON, TEXAS 77488. AFFIDAVIT OF FACT AND TRUTH Page 1 of 230 31 32 33 34. 35 36 37 38 39 40 a1 42 43 45 46 a 48. 49 50 51 52 53 54 55 56 57 58 59. 60 1. The official BIRTH CERTIFICATE pertains to the Registered Owner of the attached CERTIFICATE OF LIVE BIRTH referred herein as Certificate of Title, and the affiant believes there is no evidence to the contrary. 2, The Registered Owner of said Certificate of Title date of birth is March 19, 1959 at 3:16 a.m.; with registration, creation of corporate entity, and registrar signature dated March 19, 1959, as recorded April 2, 1959; and the affiant believes there is no evidence to the contrary. 3. Thelton-Ray-Junior: Perkins and THELTON RAY PERKINS JR. (as reflected on the CERTIFICATE OF LIVE BIRTH number 46239), the party named in said attached Certificate of Title is the same party as one of the Registered Owners: Perkins, Thelton Ray Junior; and both as one in the same of said attached Certificate of Title, 4, Thereafter the Registrar of Titles shall treat said Registered Owner as having attained the age of majority at a date 18 years after March 19, 1959, the date of birth shown on said Certificate of Title registered on April 2, 1959, and the af JURAT STATE OF VIRGINIA COUNTY OF PRINCE WILLIAM ON MAY 1, 2014 before me, tf Aol Z ae! doe, Public of ae thel fon Fas, Tr. Resing ‘Who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to. this instrument and acknowledged to me that he executed the same in his authorized capacity and that by his signature on the instrument the person(s), or the entity upon behalf of which the person acted, executed the instrument. | certify under PENALTY OF PERJURY under the laws of the State of Virginia that the foregoing paragraph is true and correct. SEN WITNESS my hand and official seal. ___Notary Public Signature NOTARY SEAL AFFIDAVIT OF FACT AND TRUTH Page 2 of 2