7/1998 - A project of the O.G.S. Cemetery Committee - Use this form for reporting:

LOST & FORGOTTEN CEMETERIES

Date: ________________

__ phone call __ correspondence __ in person __ web; received by____________________________

Informant: ______________________________________________

Address: _______________________________________________

City: ________________________ State: _________ Zip:_________ Phone (______) ____________

Name of cemetery _________________________________________ a.k.a. _____________________

[family, land owner, community, etc.]

Location - [1/4 section ______; section #______; Town _________ & Range _______

Access: [side N., E., S., W] _________ of [road] ______________________________ which runs

between ________________________ [road/street] ____________________________[road/street]

[This cemetery may be the same as ___________________________ listed on page __________ in Ohio Cemeteries 1978 or Ohio Cemeteries 1990.]

Additional Information known: __________________________________________________________

Tombstones in existence _____ [approx. number of] ; _______ [year]

Individuals known to be buried there: _____________________________________________________

[Attach list with names & known birth/death dates]

Land record found in Deed: _________ Volume ___________ Page

References cited and attached: _________________________________________________________

[Church history, published county history, family records, township maps, etc.]

Columbiana County