Marriage Certificate - Creech, Patricia M_5/7/2001rei.� n�e.0 e.
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STATE OF INDIANA
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APPLICATION FOR MAHRIAGE LICENSE
GIBSON
IC31-7-9-1. Fumlthinqfaltelnformetionuponepplylnpforllcenfe.
A person w�o knowingty lurnie�es lalse intormation to a clerk ol tha
circuit coun when I�eperson applies lor a marriage license under IC
31-7-3 commits a Class D feiony.
MALE APP�ICANT
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CONSENi OF P�RENiS. PAFENl, OP GW RDUN
W�. N� O�t�nb 01 Nu �OO��n4 MnpY 0'n Confml lb tlti� marryye.11 enlY � O�nN �qm.
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Dete ol ADD���E��on
Female Applicant 50> No ❑ Yes ❑
If No, MeOical Examination or Report DateC
Name ol Physician
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APVLICANT
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�LNNOWLEDG4ENi
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tClnO+'IS00men� G[)YY OI IIYpiWf MINM1.
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SI�.IOIIItlI�M ) I��M//�X�mN�IVM�n1YT�:MO�An
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CONSENT OF >APENTS, VAqENT. OH GUAfl01�N
wr. N� yrentl ol Wa �pqif nl nn�Ey Oir� ronuni la Wa nupu9e.11 prYy pm wml ai�n�,
�1�1� 1�[h v�K� mi�� IM [4nNN OI NI OM01 p�RT YM�[!W ly
S�monnci�n� �
Ca+mY ol � v.
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MoNU 10 �
SvoacnWa�na�womtoM�onmeNn_mrol t9_
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COMPIETE IF MAXNIACE LICENSE ISSUED BY ORDER OF COIIRT. A marriaga license naving Oeen reluseE Io tne aEOVe nemea panie�, t�e
Counry Coun. Dy written oraer issue0
enE IileU in aut�orizas ana eirecte Ne inuance oi e marriage license to lna a0ova namea panies.
RETURN OF �1fARR[AGE LICENSE AND MARRIAGE CERTIF7CATE
I rerdi tha[ lhere wes filed in my office a marriege license issued 6y the Clerk of /LJhe GSreuil Caurt of Gi6son County, fndinna,
deted � `t , euthonzing the marnege of �¢�� (� il/�� end
� �.t — � ) %%2 �.A2� .
f- f��u/rj' h'`er/c'e/{�6pfyQ�th�e�t t�h�e fol n mame e certificate was filed in m of e:
/�"" '^��'✓� �-��L g (neme, certity t at o 9 (date), at �� in
Countg Indiene. ' of County,
�' (state), and � of � �unty,
(ata[e) were married by me es authonzed under a meaiaBe (irense that was isyued 6y the Clert of [he
Circuit Court Ci6son County, Indie , dated r7 . �
Signed 6y , /j�/ (official �designetion)
FTled end mrordcd in attrordmce with �the lewt of lhe Stele of Indiane on .�q,�,.��� (da[e).
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