Marriage Certificate - Czoer, Llewellyn K_9/28/2009�
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Form prescdbed by �ndiana State of Indiana
State Department o( Health
UnderAUthorityof Certified Marriage License Number:2007-5
IC37-11�-0
Gibson County P.pPfication Date:09/04/2007
Groom Bride
Name Thomas Jarnes Czcer Name lJewellyn K Mcclellan
Birth Date ov28n959 �Birth Date oz/>>/���
Residence 650 East 7025 South Residence 65o Easi io25 Souih
HaubstadC IMiana 47639, USA Haubstadt, Intliana 47639, USA
County of Residence �itson County of Residence cibson
Place of Birth Ohio, UsA Place of Birth Kentucky, us4
Dependant Children Dependan[ Children
Fathe�'s Name �onn cnanes czcer Father's Name Mitchell Terry Mcclellan
Fathei's Residence Father's Residence
EvansWle, Indiana, USA Glassglow, Kentucky, US4
Birth Place of Father Ohio, USA Birth P/ace of Father Kentucky, usn
Mother's Name �uiie a,n czcer Mother's Name Goldie Mae Webb
Mothei's Maiden Name �oudner Mother's Maiden Name scepnens
Mother's Residence Moiher's Residence
EvansvBle, Indiana, USA Illinois, USA
Birth Place of Mother lov.a, USA Birth Place of Mother i���ois, usc,
Date of Marriage 291h day of September, 20W
City/TownofMarriage PRWCETON County cibson
State Country
Name of O�ciant GARY ARNOLD TIfl2 MINISTER
License Issuing Clerk eecky woodbum
The information above is a true and accurate copy of the information on file with the Couniy Clerk regarding the
Application for Marriage and the Marriage License issued by this county.
Clerk o7 tl� Gibson G7cuit Court, Cw�bson County, Indiana,
Seal tltis 2QthdayolSeptember,2009
SL�lr�c.�.."�" WGXd'-O�.RJi/�`
� � Clerk
MLn: 2007-5