Marriage Certificate - Goedde, Paula Ann_8/6/2012�;.�, Indiana State
!C,- �artment of Health
RECORD OF MARRIAGE
VANDERBURGH
INSERT NAME OF COUNTV
GROOA4
Name IPrint in Fulq
GOEDDE JAMES VINCENT
��� First MiEdle
Residence (Address) GZBSON
305 W HAUBSTADT County
City or Tou•n ��STADT State IATDIANA
Is Residence Inside Cily Limits? Is Residence on a Farm?
Yes ❑� No ❑ 1'es ❑ No ❑ X
UsualOccupalion EQUIPMENT OPEP.ATOR
Education (Specity Highest Grade Completedl 12
Father's Name tiINCENT A GOEDDt� �rth Place INJZAl�,A
1Sother's Name MARY AGNES GOEDLff]rth Place INDIP1dA
Name (Legal Name Before This Marriage—Print in Full)
DEFFENDALL PAULA
Laei Firsl
Residence (Address)
COUNTY
RACE
White ❑ �Black ❑ Am.lndian ❑
Other ❑ (Speci(y)
Age of Groom Place ot Birth
IState or Foreign Country)
38 ZNDIANA
PREVIOUS MARiTAL STATUS
Never Married ❑
LAST MARRIAGE ENDED BY:
Death ❑ Annulment ❑
Tolal Number of Previous
Divorce � xMarriages �I—
Date Last Marriage Ended � q�z
BRIDE
RACE
R'hite ❑ X.Black ❑ Am.�Indian ❑
���edie Other ❑ (Specify)
Counly }+a*TnFRp
2613 HILLCREST TERR
City or Town r State �
Is Residence Inside City Limits? Is Residence on a Farm?
Yes ❑'!. No ❑ 1'es ❑ No ❑ X
Age o( Bride Place o( Birth
(State or Foreign Couniry)
PREVIOI35 MARITAL STATUS
Neve; \fa:ried ❑
GsualOccupation LAST h1ARRIAGE ENDED BY:
° Death ❑ Annuiment ❑
Education ISpecify Highest Grade Completed) Total Number o( Previous
Father's Name Binh Place Divorce �I X�tarriages ��
;.fo[her'S Name YEtdNETH P RUEGEFB�rth Place Zn�ir�a Date Last Marriage Ended 1997
CAROL ADIN HAPE INDZF•SIA
This Application for License Expires on
PLACE OF MARRIAGG ` OFFICIANT `> � c''� ,
CitporTown [-[nnsv����e County V� ��j��y� hame �e�_ �"\.r�.ro� �• K��S"1G
Signature /� . � �( (�f^� Trtle 1 n_ -.�
..rr......... IL _.,_ 1% �)�Da/A/n QcY1Ci.�n�J'1�r��5��e^
Signature ( n � . �\ � �•�
of Bride ��� y
Date o( "�
A1arriage �� ^ . 1 \ �
AIDS Education Acknowledgement5igned _
; 15 �-� �
�- �:-�'
Religious Objection Signed
CLERK OF COURT: Detach Record of i�larriage and (onvard same at close o( each calendar month �o Indiana
State Department of Health, Vital Statis�ics, Section B 4, 2 lbrih i�leridian SIreeL P.O. Bo� 6016. Indianapolic, Indiana
a6206-8715.
Date of Recordi
262
219
Signed MARSHA ABELL Clerk of VANDERB'�7RGH Circuil Court "
Insei[ Name oE Covn[y
SDH06�025�32 LG 3Li�3�16 �
AIAHHIAG_/POL UE\` 1
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