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“What are the ramifications if the same person, presumably Grandma, did in fact sign in both box 18a (as Madelyn Payne Dunham) and box 19a (as Martin Blaine E-?-n). Would this mean that the document must be declared bogus? I don't think we could conclude this!

“It's my general impression that virtually all the major players involved in this entire mess, including Grandma, were very adept at “gaming” the system.”

What I like about this document is that if accepted on its face, it doesn't require any conspiracy on the part of Grandma. It says she is reporting a birth in Kenya.

My impression is that this form is not a take-home-and-fill-in form, but rather a form that would be filled in by the local registrar office clerk based on a visit to the local registrar office by the witnesses. The witnesses would give the information, the registrar would type it in in the approved format and language (that couldn't be known to a person who was not a registrar clerk) and then the witnesses would be asked to sign the form in front of the clerk, then the clerk would sign. All three signatures are on the same date, presumably at the same office visit.

The name “Blaine” appearing as the legible middle name of the 19a witness and also as the last name of the attorney who put this on the web raises the possibility of a family link between the two. This further reinforces the possibility that the 19a witness is a real person and not made up by Madelyn.

Professions can run in families and the 19a Blaine middle name witness could be an attorney as well, perhaps Madelyn's family attorney who might actually be the source of the document, but it could just be a friend.

The document, if genuine, was altered on its face with the footnote sometime after 1982, so if the 19a witness who signed the document was the person who gave it to Ohio attorney William E. Blaine, the witness would have had to have obtained a copy of the document subsequent to 1982. Perhaps Madelyn and her attorney or friend of 20 years at this point were involved in trying to clarify BHO II’s legal status at that time, for example to help him get a US passport.

"My impression is that this form is not a take-home-and-fill-in form, but rather a form that would be filled in by the local registrar office clerk based on a visit to the local registrar office by the witnesses. The witnesses would give the information, the registrar would type it in in the approved format and language (that couldn't be known to a person who was not a registrar clerk) and then the witnesses would be asked to sign the form in front of the clerk, then the clerk would sign. All three signatures are on the same date, presumably at the same office visit.

You make an excellent point and you are very likely correct on the matter concerning the two signatures. However, for the sake of discussion, in case the inevitable questions reqarding them arise, allow me to play 'Devil's Advocate' on this.

Could it not at least be conceivable for Madelyn to have gone to the local registrar's office and provided the required information to be typed onto the form. She could then have stated that her co-signer, Martin Blaine E-?-n, was busy with clients, customers, meetings, sickness, or whatever, and could not come in personally. She, however, would be happy to take the form to him for his signature and return the same day to the registrar's office to complete the process.

Regarding the above 'forgery' scenario, IMO -
Loosey goosey and unlikely? Yes!
Impossible? No! (But this wouldn't invalidate the authenticity of the document)

THERE IS NO CERTIFICATION ON THE FORM THAT EITHER OF THE SIGNATURES IN BOXES 18a or 19a WAS WITNESSED BY ANYONE.

I wonder if an image of Madelyn's signature is independently available anywhere on the web? I looked a bit for it but couldn't find anything. It would help authenticate the document if her signature could be shown to match that on the Blaine COLB application.