Marriage Certificate - Jacobs, Stacy S_4/12/2010�
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� '� � �� � State af Ind�ana
�� Depafuren[ d Health
�p ��°"''°` � Certified Marriage License ��-�
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Gibson CouMY Aav�LOn oare: mrzs2ooe
Groom Bride
Name onvw t�ns ra�c�x� � Name SraC s.acOeS
8irth Date t2rtaigso Birth Date �atr�i9se
Residence eisssrour
Residence 9u 5 STOU7
�R1NCEf�N. ��de+e 47670. USA PRINCEfqd. Irdare 47fi70. USA .
Couniy of Residence �+'�san Counry of Residence �r'bsm
Place ol Birth ��a. usn Place of BiRh �n�ara, usn
-Orper.dar.: Chi:�:en - .:.eyzndant Ci�P�men -
ADnM NE/iSE, qqRp1•1 Jq�B�. A�GtiAN (�IwfnHi
Father's Name HEFtBERi N Fd1SSEL1 Fathets Name �o J iimEMqN
Fathers Residence Fathei's Residerroe
Irtw�a. USA Uidwu. I15N
Birth Place of Father �, u� Birth P/ace of Father
oxbar�a. usn
Mothers Name ooaoittr � vouraGS�ppp Mother's Name �MRO� � rtFa�r
Motlrers Maiden Name AqpuN Mother's Maiden Name Hq�E
Mothers Residence Mothets Residence
i�u. usn �w�. �
Birth Place of Mother �m,ecy. us4 Birth P/ace of Mother triaarra. usn �
Date of Marriage sn aay a apra, a�oa
=::�r,?otrr. cf Marr,'ag.� oonr;c-rny Cc�.ir.ty ;?.us —_ " – .�
Name of Oflrciant �i t��.s Title rt�v�np.ID
License /ssuing Clerk eedcy wao�m
The infortnafion above is a We and accurate copy of fhe infortna6on on file with ihe Counly Clerk regarding the
�cation for Marriage and the Marriage License issued by thls county.
; Clerk oI f1e Gibspn QrarR Caat. C�sm CofoRy, ln6ana,
S2al tlit 777hdaYdApd,2008 '
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