Marriage Certificate - Iverson, Tricia Kay_12/28/2009t«o n.,aa.a ry
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GIBSON COUNTY AUDi7o�a No 80 _ O��
STATE OF INDIANA File 0907-M1i1-000476
APPLICATION FOR MARRIAGE LICENSE ono�ros
HENDRICKS COUNTY Date otApp6ca5on
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Name NICHOLAS RALPHIVERSON
Date ot Birth 08117178 —
Place of Birth State or foreign country) MINNESOTA
Residence Ad�ress 778 TA7EAM DR County HENDRICKS
DANVILLE IN 46722
Previous Maritai Status: NEVER MARRIED No. of Previous Marriages
Last Maniage Ended By: Date:
Dat= of birth verified by: D �Dd.dsli B�itliCet 0.�ter
N 1. Are you now or have you ever been adjudged to be of unsound mind?
If answer is'yes; has the adjuditalion been removed?
N 2. Are you related to the female appiicant closer than second cousin?
N 3. Are you now under �he influence ot an alcoholic beverage?
N 4. Are you now under the influence of a narcotic drug?
5. Lis� of full names of any dependent children
6. (a) Full name ot applicanCs tather THEODORE RALPH IVERSON
pl adopted, list adoptive parents only)
Residenceoilather(itdeceased,sostate) INDIANA
Bitlhplace of father lstate or foreign country) SOUTH DAKOTA
(b) Full maiden name of applicanYs rtrother MARY ELIZABETH JORGENSEN
(If adopted, list adoptive parents onty)
Residence of mother (it deceased, so sfate) INDIANA
BiMplace of mother (state or loreign country) SOUTH DAKOTA
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FEM4LF APPLICANT
Name TRICIA KAY VENDRELY
Date of Birth 05127180
Place of Birth (Siate or foregn wuntry) INDIANA
Residence Address 778 TATEAM �R County HENDRICKS
DANVILLE �N 46722
Previous Marital StaWS: No. of Previous Marriages 2
Last Marriage Ended By: DIVORCE Dare: 2008
Date of birth verified by: D D�i,dsl:c B�ifiCert 0�7er
N 1. Are you now or have you ever been adjudged to be o( unsound mind?
If answer is'yes; has the adjudiration been removed?
N 2. Are you reiated to the male appiiwnt doser Nan second cousin?
N 3. Are you now under the intluence ot an alcoholic 6everage7
N 4. Are you now under the influence of a narcotic dmg7
5. List of tull names of any dependent children
6. (a) Full name of applicant's father DAVID CHARLES VENDRELY
pi adopted, list adoptive parents onty)
Residence of taiher (if deceased, so sWte) INDIANA
BiMplace of faNer (stale or loreign country) INDIANA
(b) Fuil maiden name ot applicant's mother SHARON IYNN LRTON
Qf adopted, list adoplive parents onty)
Residence of mother (f deceased, so state) INDNNA
Birthplace of mother (sWte or foregn aunVy) INDIANA
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RETURN OF MARRIAGE LICENSE AND MARRIAGE CERTIFICATE
I certify that there was filed in my office a marriage license issued by the Clerk of the Hendricks County, Indiana, dated
JULY 7, 2009 authorizing the marriage of:
NICHOLAS RALPH IVERSON and TRICIA KAY VENDRELY
I further certify that the following marriage certificate was filed in my office:
I, JONATHAN M HOOVER certify that on 07126109 at DANVILLE in HENDRICKS
NICHOLAS RALPH IVERSON of HENDRICKS County, INDIANA
and
TRICIA KAY VENDRELY of HENDRICKS County, INDIANA
County, Indiana,
were married by me as authorized under the marriage license that was issued by the Clerk of the Circuit Court of
Hendricks
Counry, Indiana, dated JULY 7, 2009
Signed by: JONATHAN M HOOVER STAFF PASTOR
Filed and recorded in accordance with the iaws of the State of Indiana on Jul 30, 2009.
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Signed v��v� \\ Clerk
Hendricks C nty Circuit Court
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