The Brigham Young Center

Mrs. Dorthe Morrell,
Wanship, summit Co.

Dear Sister.

I have been instructed to send you the enclosed form.

You will please fill in your name as it was before your marriage after the word Dorthe, and sign Dorthe Morrell on the lines where it is written in pencil. Some one should witness your signature. Return the form here after you sign, & send Bro Morrell's address. The fee is $10.00 which either he or you will be required to pay.

Your Bro. in the Gospel
D. McKenzie, Sec.