Marriage Certificate - Perry, Linda F_8/12/19981� —'__ _
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` • STATE OF INDIANA
APPLICATION FOR MARRIAGE LICENSE
�GIBSON COUNTY
• No.
IC�1-7-9-1. Fumishlnylalulnfortnatlonuponepplyingforlieenu.
A penon who knowingly turnishes false informetion to a clerk of the
'— circuil court w�en the person applies for a marriage license under I C
31-7-3 eommits a Cless D felony. � �
S
APPIICANT
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�CKNOWLEDGMENT
I�ekro�NOp� IMI I Mn r�eairsU inlorm�tqn �parEiep Ganqerwf eommuniraWe C�wata
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SipluWnd�cqc�m .���Ul^t I�/LL� Date ��L/ C�
F�ia �/
7�aT7 "/O
Date of Application
Female Appticant 50> No ❑ Yes ❑
If No, Medical Examination or Report DateO
Name of Physician
FEYAIE APPLICANT
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Greryuf Marihl5blm' Ner�r MamM
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GONSENi Oi FMENTS. F�FENT, OIl dUMOI�N
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SYNO11nUiuu � �:
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GIGm C4c�i� Cart
CANSENT OF P�HENTS. P�RENT, OR GIlAPOIAN �
WL ��a panntf al �pia a001kanl �enOY flim confenl lor Nia martu9e.II on7 orw pu�nbqm.
�tale Iacte .�i� mate 1he conunt ol [M a��er puent unnecavry
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Counry o� � u:
F�tMr 10 •
MpNM ID I
$opfcnpeC �M swom ta Eelon me VJ� _ Eay ol t9—
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COMPLETE IF MARRIAGE LICENSE ISSUED BY ORDER OF COUPT. A marriage license �avinq Deen reluseA to t�e above namaC Dartiee, Ihe
County Court, by writlen or0er iSSUeE
enA IileO in authorizes and airects Iha issuance ol a marriage license to the eDOVe nametl partiee.
RETURN OF MARRIAGE LICENSE AND MARRIAGE CERTIFICATE
I certity lhet Nere wes Sled in my offire a maniage Gcenae iasued 6 the Clerk Jo%f the �ireuit Court of Gibson County, Indiana,
dated � euthorizing [he merriage of �w tt..._i il, . j/!/]iL��l �d
�, �, .3 �1u.�.,�.�, --�
I er fy th the ollowing memage rertificete wes filed in my otfire:
I,�y����• (n �), certify t t m � y� (date), at in
b(�1Oi�^� Caunty. Indiana,-y � of ,�4��V County,
��'-' (etate), end �%�-� 3. of �� County,
��• (atate) wex married 6 me ea autharized under a merriege licenae that wae issued by the Clerk of the
LSrcuit Cour fGi m Coupty, diana, deted 9
Signed by: � � , (official designation) L
FSled end mrorded in ettrordence with the lewa of [he State of Indiane on �� ��%5�7date).
Signed /Cl�(.d�14.��W� Clak
,�sau..�mn � r�idnv Gibsan Cixui Court
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