Certificate #23624 County of Buckingham District of Slate River Name: John Allen Self Male, White, Married Wife: Kate A. Self Birthdate: June 1 (no year listed) 63 years, 5 months, 21 days Occupation: Farmer Birthplace: Buckingham, Va Father: George H. Self (born Buckingham) Mother: Amy Maxey (born Buckingham) Date of Death: November 21, 1922 Burial: Buckingham on 11/23/1922 No informant information listed