CHEROKEE NATION Registration Department P.O. Box 948 Tahlequah, OK 74465

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APPLICATION FOR CERTIFICATE OF DEGREE OF INDIAN BLOOD

Complete the application in INK. List the name(s) of your ancestor(s), the tribe, the crrect roll number(s) from the FINAL ROLLS OF CITIZENS AND FREEDMEN OF THE FIVE CIVILIZED TRIBES. Cherokee Nation (Dawes Commission Roll Book) for the ancestor(s) listed with a blood degree and to whom you are tracing; and any CDIB reference. APPLICATIONS SUBMITTED WITHOUT ROLL NUMBER OR CDIB INFORMATION WILL BE RETURNED TO YOU. Use Ancestry Chart to assist you in filling out this form. PROCESSING TIME IS APPROXIMATELY FOUR TO EIGHT WEEKS!

APPLICATION INFORMATION:

1.	__________________________________	1a.	__________________________________
	Name at Birth and Current Name		Mailing Address
1b.	__________________________________	1c.	__________________________________
	Date of Birth		Place of Birth
1d.	__________________________________
	Social Security Number

PLEASE NOTE: If the ancestor has a CDIB, provide a copy of the ancestor(s) CDIB, only answer the questions to the CDIP ancestor(s), and skip to Question No.8

ANCESTRY INFORMATION:

2.	______________________________	_______________	________________	____________________
	Name of Father	Tribe	Roll #/CDIB	Living or Date of Death
3.	______________________________	_______________	________________	____________________
	Name of Mother (Maiden Name)	Tribe	Roll #/CDIB	Living or Date of Death
4.	______________________________	_______________	________________	____________________
	Father's Father (Grandfather)	Tribe	Roll #/CDIB	Living or Date of Death
4a.	______________________________	_______________	________________	____________________
	Father 0f #4 (#8 from chart)	Tribe	Roll #/CDIB	Living or Date of Death
4b.	______________________________	_______________	________________	____________________
	Mother of #4 (#9 from chart)	Tribe	Roll #/CDIB	Living or Date of Death
5.	______________________________	_______________	________________	____________________
	Father's Mother (Grandmother)	Tribe	Roll #/CDIB	Living or Date of Death
5a.	______________________________	_______________	________________	____________________
	Father of #5 (#10 from chart)	Tribe	Roll #/CDIB	Living or Date of Death
5b.	______________________________	_______________	________________	____________________
	Mother of #5 (#1 from chart)	Tribe	Roll #/CDIB	Living or Date of Death
6.	______________________________	_______________	________________	____________________
	Mother's Father (Grandfather)	Tribe	Roll #/CDIB	Living or Date of Death
6a.	______________________________	_______________	________________	____________________
	Father of #6 (#12 from chart)	Tribe	Roll #/CDIB	Living or Date of Death
6b.	______________________________	_______________	________________	____________________
	Mother 0f #6 (#13 from chart)	Tribe	Roll #/CDIB	Living or Date of Death
7.	______________________________	_______________	________________	____________________
	Mother's Mother (Grandmother)	Tribe	Roll #/CDIB	Living or Date of Death
7a.	______________________________	_______________	________________	____________________
	Father of #7 (#14 from chart)	Tribe	Roll #/CDIB	Living or Date of Death
7b.	______________________________	_______________	________________	____________________
	Mother of #7 (#15 from chart)	Tribe	Roll #/CDIB	Living or Date of Death