Marriage Certificate - McClellan, Llewellyn K_9/28/2009- _._� - —
Form prescribed by Indana • State of Indiana •.
State Department of Health
UnderAuttqrityof Certified Marriage License Number:2007-5
IC31-11�-4
Gibson County App�iwfion Date:09/04/2007
Groom Bride
Name Thomas Jarnes Czcer Name Llewellyn K Mcclellan
Birth Date OV28/1959 �Blrth DBtB Oz/>>����
Residence 650 East 1025 South Residence 650 Easi 1025 South
Haubstadt, Indiana 47639, USA Haubs[adt, Indiana 47639, USA
County of Residence cibson County of Residence Gitson
Place of Birth ohio. USA Place of Birth Kentucky. Usn
Dependant Children Dependant Children
Father'S Name John Chades Czcer Father's Name Mitchell Terty Mcclellan
Fathei's Residence Father's Residence
Evansvdle, Indiana, USA Glassglow, Kentucky, USA
Birth Place of Father Ohio, USn Birth P/ace of Father Kentucky, US�+
Mother's Name �mie ann czcer Mother's Name cadie Mae webb
Mother's Maiden Name �oudner Mother's Maiden Name s�epnens
Mothe�'s Residence Mother's Residence
Evansvdle, Intliana, USA Illinois, USA
Birth P/ace of Mother iovra, usn Birth P/ace of Mother ii��ois, usa,
Date of Marriage z9ch day of sepcember, 2o0�
Citylfown of Marriage PRINCETON County cibson
State Country
Name of O�ciant GARY ARNOLD Title MINISTER
License Issuing Clerk eecky woodbum
The information above is a lrue and accurate copy of the information on file with the County Clerk regarding the
Application for Marriage and the Marriage License issued by this county.
CIeAC of tFe Gibson G}cuif Court, Gibson County, IrMiana,
this 2&h day o7 September. 2009
Seai
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Clerk
MLx: 2007-5