4. Name and address of person, if any, who put you in touch with informant--

5. Name and address of person, if any, accompanying you--

6. Description of room, house, surroundings, etc.

Personal History of Informant

1. Ancestry—father, Jeff Wells; mother, Tilda Bailey.

2. Place and date of birth—born in 1861 in Monticello, Arkansas.

3. Family--

4. Places lived in, with dates—reared in Monticello. Lived in Pine Bluff thirty-two years, then moved to Little Rock and has lived here thirty-two years.

5. Education, with dates--

6. Occupations and accomplishments, with dates—Hostler