Marriage Certificate - Richardt, Lana_3/8/2001418
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•STATE OF IHDIANA
APPLICATION FOR MARRIAGE LICENSE
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OUNTY Dats of Appliption
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Name ol P�ysician � � �� �'
No. �
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GIBSON C
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COYVLETE IF YARR��GE IICENSE ISSUED BY OflOEP OF COUPT. A marriaga Ik<nse Mvinq Oem rel�seE lo Ne aCwe nameE perti<s, u+e
����, Cou4 oy �rinen oroer iuuea
�Q ���� � _ evNOrixn enG airetls t�e i35uance ol e marriaqe license to I�a eWVV nameE WM1�es.
REfUR� OF MARRIAGE LICE�SE AND MARRIACE CERTIFICATE
t n��$, Na� N�r� �••m (il�d in my affitt e merriege licenx iseued 6y tLe Clerk 4� the Ci+euit Court of GiWon Caunty, Indime,
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defed y' , euNoriiine We memege of ��`+'^'�,A
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Ifilrlher rtifY U+at the oll wing myrieye certificefe was filed in my offire: ./�. � r. �
t `� (nemt ttrtify that aa //
(date). ef �OA40�<LIi� N
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lbunty, fn ea&yg � , ' /� p — of � CovntY.
.�'.�"' (ete W. end � —�� al �<�-�—
,.� (atate) wex mn+ried 6y me en euthonzcd under n merneSe littnse that we.+ ittued by the Cluk of the
Cutuit Court f Gi on County, fpd' a, da[ed "�" j
"� ���y�,'e A � �-�- � ' �� (offival designatia�)
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FSIed md rmord�d (n eccoldmcr wilh the leweoof the Stete of lndime on ��dem).
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