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[This is a typewritten form that is filled out by hand. Handwritten parts are in quotation marks here]

Pennsylvania Historical and Museum Commission

Bureau of Museums

P.O. Box 1026

Harrisburg, Pennsylvania

Date: "6/24/72"

Home Address: (Street) "House #137"
(City, State) "Eckley, Penna." (Zip Code): [left blank]

Home Phone: [left blank]

Occupation: "Housewife (widowed)"

Hobbies, Crafts or Other Skills: "None (watches T. V.)"

Business Address: (Street) [left blank] (City, State): [left blank] Zip Code: [left blank]

Business Phone: [left blank]

Previous Occupations: (years) "Housewife (had 8 children)"

Religion: "Roman Catholic"

Place of Birth: (town) [left blank] (State or Country) "Prussia"

Year of Birth: "1898" [In the left margin is written "131/132 1900 census"]

Other Places of Residence (years) "Moved to Eckley at age 6 months & has remained in Eckley ever since."

Father's Name: "Andrew Laganoski" Birthplace [left blank]

Father's Occupation and Special Skills: "Miner (was killed in Eckley mine in a cave-in, 1917)"

Mother's Maiden Name "Catherine Swankosky" Birthplace [left blank]

Mother's Occupation and Special Skills: "Housewife--had 15 children--9 which lived"

"A. Bruno Laganoski's sister..."

"B. Reuben Spire (husband), born in 1883, died in 1957, asst. foreman in the Eckley mines 1910-1938, he 1938-1948 died of miner's asthma." [In the left margin is written "88/89 1900 census"]

"C. Lived in 'Backstreet' house #19 then when she"