Marriage Certificate - Kiesel, Terri_10/7/1991ro.v r...�ner e� �
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��_���;• APPLICATION FOR MARRIAGE LICENSE Fv�
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Gibson County 7-�� g 7
Unre N APPlicntiun
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ALL OUESTIONS NU&'! BE ANSWERED. IC 0L13E pv�etlEeE'P�lu �uumeet-Wpoevr p�oevn� tEe Ivu�nw ot � Ilcev�e b mvry Ey my I�In naumeo�. rcpmunWbn ar
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MALE APPLICANf
Prevlou�llv�ul5uom: NeverM�vieE{ OR
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1. Am you oo� ot G�v� you eve� Cttv
Wjutlged b Oe af upwmtl mlpE? Iv'� Ye� ❑
1f mver b'Tet : Lu Wv WluEfuuon Oaen rtmavaE] No Ye O
2. Aro You �tttic4C �ItG � ttw�mianEle Glrc�u! No Yv�O
i. An Yau n1�W b tE� fem�le �pOGCmt
[leur tE�u �ewvE counv? Fo Ye� O
�. Are you ne� wEe� tpe inflmnce of inbzln6nR ��9uor? Iv' Ye� p
5. Art yau oe� uvEer tpe in0ueece al � n�rtotie Em�! No Ye� ❑
E. U�t tEe lull n�me� of �ny EepeoEev� cElltlmn.
], Are you reyuveC Oy �ny mun order or areo�
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utifhcbry prvo( tE�t You �re In campll�va �ItE mY �rt e`Eer a� eNen
umed lor I�nr euppoM.
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noiaeo«a�mom..wacce..eaw.uml .C�a+..nO�.w ___.
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C0.15PNf OP P�AENIS p�REN! OR CUARDIAY
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FEMALE APPLICANf
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l Are you now uv0sr N< Inlluevice oI ivbzic�tivg liyuof! N1 / Yea O
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6. Li6 We full n�mn of �vy Eepeopen� eptlUrcn.
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�o.�aaonm�.ro��a.xm�o«eua.��+ no� v..�
u.e..er ia'..: . u�..w�ima w.� m�. nynucumn ee.eeemw=�.a ey
tia(�[bry proo( tpu yov �re In Compll�vtt �tN �vy teurt orde� o� orCen
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lO\SE\T OF PAHE\l5. PARL\T OH Gl1AROlA\
N'e Ne pumu. d Nb yplk�nt Ee�WY f�ve w�ueN lar Ni. m�rtl�6e 11 oNY ane p�emt
�I«�. �YI<(acb r1�W �eedR ILe mbevl W ILe WAee p��eel unn4sa�e�.
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CONPLETE IF MARRIACE LICENSE ISSUED BY ORDER OFCOURT.Amarriagelicensehaaingbeenretueedm[heebovenemedper6ee,[he
��++�h Court by vritten order f�rued eM fiial
N euthotlzo end d4ecte �heueuaaedomarriagelkc�uem�heaborenamedpurtivr.
REfURN OF MARRIAGE LICENSE AND MARRIAGF. CF.RTIFICATE
BE /T REh1EA1BERED. thrx ww ��ed in my o/(oe a marriage li�<rue isued by tM1r Clerk o! �he Gl6wn Cireuit Court o( Cibron Counry, /Miaw,
dalMlhe �'�/, aaYOJ 19 �__� aulhorcirt¢thejoinirrg�oReNe.a�Au�banda.dwiJe
Be it /urNO ronmibrrn( thr/o(bmi� mamqyec¢ni/icateuws lifN !n my o//re �omlC
.. � .'f • hurbY cmi/v ihat on th '�� aay o/
onee�ouarW ninehuidradaM - t Caunty o/ -�
Smb o/ 1Mian C ' - ' �( - ' � • ^ Counly. Siate oj .
aM Bne• �/ eou,uy. Sm�e o/
vere b� me unif¢d in maniaYe o+ authorizrd 6y a manbye licrnu usurd /or ehnf purpou 6y fhe Clerk o/ the Gibson Circui( Couri oJ GiMon Comry.
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Datei Ni�_ / w,.y o/ 19_ Sytnod -
� O//icial Daignation - _
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