Marriage Certificate - McDowell, Misty L_12/16/1998� �e�a F
ue.v ma seva a
Hra �.�e. wo.w
a c e�-ra
�
3��5
STATE OF INDIANA
�
APPLICATION FOR MARRIAGE LICENSE
No.
File
GIBSON COUNTY �^a-9�
ate al Applicetion
IC31•7-&1. Fuml�hinqlalssinlormetionuponepplylnplorllcanie.
A person wh0 knowingly turnishes telse inlormation to a clerk ot t�e
circuit wurt w�en tne person aDG�ies lo� a marriage Iicense under IC
31-7-3 commits a Class D telony.
MALE 11i0LIC�NT
. � � �� u // _ YIJ-���....._.��
o.,.a�, M�" 9� " �Ss�
�. a a.9, �su�. � �,,,K� �„� F�.y�..^ ", _ ���p �/
. .t /d.rr. yqnu ,�s� e� n/J�X�,/-.�.�'�� wL<-ewr. -Z/Y
l� iS./`
Gewqu� Wn1�15�11u�'. H1vtIMUnWp OR NO� f 4�nuqlf _
1 �
Lul WrrurEneMBy: OeM O Me�p G �nnNm�m O Dm
D�p ol dnn nnum eY: O B�.vi Grtitiuir �O�mr ISpciM1
� v� _:a,.: �..�
1. ANyWnOwOrMnyOUer��pN11�EI�C�lOMO1VnWYnOmNC� N0� YnG
II �Iq�1l 4}'�l: Mf N� �CpqiG4On b�n r�n!pv�Et NO� .Of �f� G
]. 4� y0u �Nllq b IM I�m111 �pC4C�n1 Cbui IMn vcwq cnuyn� Nvy YM C
J. �r� ryu rov uM�r �n� �nlN�r�c� o� �n �kdwYC Mr�r�qi No�' Yn ❑
�. M� y0u M� VM�I1�! NMMC� M� n�K04t ONq� NO� Y�� �]
5 Lnl N� IW Mmn OI �nY <�W^C�n� cMOrm.
� %J� , O
e aiown.m.a.ccYC+�n�,w.
P� �aoo�w.lin eaoow. ✓�nm. oniy� �
RAi01K� 011![IIII (�I O�CMME. W �I�I�I
BiMC4C� W I�NO �SUb w Iw�qn COUnIry) S^�
(CI F�A maqan n�m� al �ppYCanl � moNn � 1'
p�.aon.e.r.ueeow.vu�m�Omn %%Z.--�-� ✓d
H�fqIM1 M moN�r (J C�c�a��C. b alale� ��
9vu�pyc� oi momer ISUtr u�omqn cwn W l
•[BNpWLEOGMENT
1�ctrw4p�� IMI I n�n r�c�rnC'n10�m�4pn rp�reilq aYK'srOU� COmmVnica0l� Owau�
IMI �n w� WI1y �nn�m1OM. m0 � N>� OI NI U�1 �Ilb IO/ �M �innl�tl c�uN� �I05 pcpVirN
��!:G�1.i�.IIO�� i��( ■
TM �Oa� �ppYC�nl M� oDIMM 10 mi�ryp pY aN 0� �Ilvmtl�qn w �qn�lun b Vv � Wv
Mna.l WOmml Ewua� ol rNqrti� M�wls.
CNn W Gwn Dai�
St�aMina��u 1 t�+narianumwiu��niwma�wnGrrm
famq d Gicam 1L/°��, ���+•wx.u� �. w...a �o,�.n.
Si9nW � (2\I '1•� . ur ��
N�v ACOnu qI�
SuOKnOM uH ��em to Mlo mr Nif ' aY ol 191L
�_ C4rt OI N� GIGm LirtM� 'favl
CANSENTOFYMENTS.P/JIENT,ONGU�RDIAN �
W�.1�� ql�nb OI IM� �OW�nI Mntr/ piK COnNnt 10! I�i� T1T�p0. II Only M� W�Ml �pn�.
�f�41�[t� �I�if� m��� IM Conaml OI IM pll�r p�rtn� uINRAVry
SYI�011lqi�n� �
camn a i •,
��wr iD.
4pM� 10 •
SoCKnpM �M ��Om b Ctlon m� Nq _ Cry ol 19_
C1Yk
Female Applicant 50> No ❑ Yes ❑ !�� G%
It No, Medical Exami tion.or Report Dated �
Name of P�ysician �
FEMALE AGGLICANT
nun�
CRVqY�M�nY151�M: NMfWrtNp
LmMa.rwq�Ena�aB♦. M�m Q Dhorce ❑ �mNm�m O D+ts
Dm ol eirtn r�nliM p�: o&n/n' yG�ertiLUb �OIMr p1c�h)
,AdR'-�AJPAiJ J-
t. Ar� Y� �. � Nv� yw �vtr DNn aEIv09� b a ol Unfp:nE mInE1 No� Ya O
Il�naweii�yp:l:uN�WryEUtionpNnrernmMi W'Oj� YnG
3. /�n you nlpW lo Vv m�M �pp6c�nt cbur Wn ��caW muainl No/j�� Ye O
J. 4re You M�v vnC�r IM intlw,u'A ol �n �kMdK Mrwp�i Nop Ya O
l 4�YW^o'�unEVN�in9wec�ol�n�rta4cErvpi N� Tp❑
5. Li�l l�e lyp Mmu OI �nY d�M�[n� fA1<M1rt
�f1q U) Fvll Nm101 �ppYt�nY� 4pw
{•r� (II�OOpIM.4alACppGV�P�nntlOnhl
FXqfM1 W IIN�� ��10eul�M. �0 �tat�l
BiM04c�W�+Ner�Stlt�wlonqnrounVy� =/�
�QIO) Fvpriuq�nnv�yol�ppfr nbmeNR
(11 �00PIN.4a� AEOptiv� P�nnb ONyj
Fnq�Me Oi GdifI! Iil OKllf W. �O sl�l�l =�
Binnp�uM�mmrrl5m�a�weqncwn•ryl =L
ACNNOWIEDGYENT
I�[kno�l�]p� N�1111�n IK�mG inlomv4pn rtt'�1EUp E�nitlWf Cwnmu�ticAOM Cwm
I��IU����u�YYV\n�mil�N. iq�Yal01N�lM��ib�lpfYNr11Y��I��IGU�[fN $��CpVU�C
immuMO�IKi�ncy�yMrom�L �� `�� �
$iqMlYle01/.00�K�n� X �I p���
)'�-7Y��
inuCOre �00��� �+� oEjM W b nn�1+M E � w rt 0� �pn�Fm b IM �Nv
�[\I10vIqOT�n� pF�YH d �l4yNU� Wli�l�.
G4rY 0� Coun Otla
SI�IOOIIMhn� � I�vY�pllim��p�11MNfpm.�IV�Smn
Cuunry oi GiOtm 1��. I\ '^ �a �oo���� 1� uw u+e cort�cl
SSnM _ �✓ •r
Nti �GOrt�s
SuEUrIpeE �M v//yf/qQ��� lo� W�I�M�f$/�Nn Eay al , 19�
•`�^�^-^,� GM�� ol N� GiOaon G4cu� Covl
LONSENT Of V1qENT$.OUiENi.OH GU�XDIAN
w�. m� wrmb o� wvoo��unt nve0v GM conpn� �onm� mani�0�. u oNy on� puent aiSm.
�VI� I�CIt v�1�C11 Tlk� N� C011YI�1 OI I�I OPN� W�lfll VluflCl3f11)'
$Iab011nCl�n� � �
caumro� � u:
i�N1( ID �
Mq�n ID �
SuC�vIEeC uy fwOm lo Celw� m� Inn _ Ery ol I9_
CMA
COMGLETE IF MARfl1AGE LICENSE ISSUED BY ONDEH OF COUPT. A marriage licenu having Eeen mlwe0 to Ne aDOVe nameC patlies, t�e
Counry eo�n, ey wr�n�� oreer issue0
and tileE in aulnorizea and Girects me iaauance o1 a merTinae licenm to l�e aEOVe nameE parties.
t
RETURN OF MARRIAGE LICENSE AND MARRIAGE CERTIFICATE
I certify at Nere was filed in my offitt e marriege L'tenae iesu 6y the Clerk of the Circuit C�ovrt of'Gip6son County, Indiana,
Ideted � 9 9 7 euthoriz(in�g �fhe�marnege of � , �' {�--�-�'� � end
� Dt. A'b�(.4-0.�
I t tSe ertity that 1 follo ' g marria certifica es filed in my o c
f J• eme�, rtif t6at o . � S y 7(detc), et in
County, lndiene, �' of Covnry,
��' (atete), snd of Comty,
•�. (atate) were merriyd 6�rymg,�p euNanze undu marriage licenae Nat waa issued 6y the Clwt of [he
Circuit Court,(I f son County, diene, de4d � 1[c.i�w� � 1 y y� .
Signed 6y �1��. LYI�.,.. .pt off3 'el designeuon)
� 21 /59�
Filed md reoorded in eCooldence with the lewa of the Stele of Indiana on . (date).
M a
a �
F �
DEC 16 1998
� �
�r � (/
�;�;-: :
GBcnN �'_�.. �. ���D1TOR �
e:.�_a AC.[.C�c�.C�.�[�.� rie.�