1

WAR HISTORY COMMISSION

STATE OF VIRGINIA

MILITARY SERVICE RECORD

Name in full

(family name): Burch

(first name): Richard

(middle name): Floyd

Date of birth

(month): March

(day): 5

(year): 1893

Place of Birth

(town): Duglas

(county):

(state): Illinois

(country): USA

Name of father: Andrew Francis

Birthplace (country): USA

Maiden name of mother: [Liota] Charlotte

Birthplace (country): USA

Are you White, Colored, Indian or Mongolian: White

Citizen (Yes or no): Yes

Voter (yes or no): No

Church (denomination): Methodist

Married: No

year:

at:

To (maiden name):

Born:

year:

at:

Children

(name):

Born:

year:

at:

Children

(name):

Born:

year:

at:

Children

(name):

Born:

year:

at:

Fraternal Orders: I.O.O.F.

College Fraternities:

Previous military service or training: None

Education

(Preparatory): [ ]

(College):

Education

(University):

(Degrees):

Occupation before entry into service: [ ]

employer: Myself

Residence before entry into the service

(street number):

(town): Lynchburg, R#4

(county): Bedford

Present home address

(street number):

(town): Madison Heights, R.R. #1 Box [ ] 2

(county):

(state):