Marriage Certificate - Jones, Sandra K_12/3/19991'%6
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STATE OF INDIANA
APPLICATION FOR MARRIAGE LICENSE
GIBSON COUNTY
ICJ1-7-9-7. Fuml�hinglelulnlormallonuponapplyinglorllcanse.
A person who knowingly furnis�es false information to a cierk ot lhe
circuit court when the person applies lor e marriage license under IC
31-7-3 commita e Cless D felony.
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♦CKNOWIEDGMENT
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ol��e Gipaon Circuit Gourl
CONSENT O� P�NENTS. P�RENT.OF GWAD�AN
we.lne paenb ot tnis �oo��unt. nere0v pire conunl lor Inn marria9e. II onlY one oannl erynf.
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F�I�er ID�
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GbrY
COMGLETE IF�MARRIAGE IICENSE ISSUED BY ORDEH OP COURT. A marriage license having Deen relused to t�e above name0 Darties, t�e
County Court, Dy wriiten or0er isSUeE
enE file0 in authorizes anG directs the issuance ol a marriage license to t�e aCOVe nameC parties.
''f RETURN OF MARRIACE LICENSE AND MARRIAGE CERTIFICATE
I cer�y that there wea fi7ed in my office a marriage lirenae iasued by the Clerk of the Circuit C�j'rt of Gi6saa Cauntg Indiana,
dated 5 , authonzing the memege of ��• � �"`"° and
1 fu er certify that e following arriage cer6ficate was filed in my office�
1, � � — � �• ��1� (neme), certify thet on 3 �5(dete), at � in
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County, Indiane, ot County,
� (atete), and � of �� County,
(atate) were memed b me as authorized under a marriege license that was issued 6y the Clerk of the
Cirtuit Court � Gibgon nt Indiane, da �y�� %,
Signcd by. �� � � I��—+- (of�cial designaLianJ
Flled and recorded in accrordance with the lewa of the State of Indiana on � j ��j fdate).
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' Signed ( Clerk
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