10/05/67 Date of Birth 10/05/67 Gender Male Hospital you were born in Winter Park Memorial City and State you were born in WinterPark, Florida City and State you were adopted in Jacksonville, Florida (Fernandina Beach, FL) Name of the physician that delivered you Dr. Joseph Bunn 255 North Lakemont Ave. Winter Park, FL Your time of birth ? Your weight at birth 9 lb 8 oz Agency or attorney that handled your adoption Anthony J. Grezik and David C. Carter When you were placed with your adoptive family Straight from the hospital somewhere around October 7, 1967 Date of finalization of your adoption April 29th,1968 Your birth name Infant Burgess "Robert Olen Hadsock" The county and court in which your adoption was finalized Duval County, Florida Curcuit Court Division C amelia@daci.com