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Marriage Certificate - Sims, Twila_5/24/2000� � :,�.a e. ��vu 9�:v Ba�n M aw+w.o-nr 4 C )1.).l � STATE Oi INDIANA • � APPLICATION FOR MARRIAGE LICENS� GIBSON IC�1-7•9-1. FumlaNngfalsalnlormetlonuponepplyinglorllcen�e. A person who knowingly lurnishes false intormetion lo a clerk ol Ihe circui� coun when the Oerson applies lor a merriege license un0er IC 31-7-3 commits e Class D lelony. NM� �= . . � � 1 4% u. ` /1, No. I File j COUNTY y���� ate al Applicelion Female Applicant 50> No ❑ Yes ❑ ,/ It No, MeCical Examina � n or Re ort Dated T—��- Q� Name ol Physician � MALE APPLICANT I FEMALE RGPLICANt Pn�qm ManpISY�W'. N�rtr ManleC O Ofl N0.01 Pnrquf Maniapn � L�f�M�Ili�i�EMOEBY. 0����❑ OivOrtl� M�nulmen�❑ O�le /� �neo�mnnnn��ee � ❑BinnGniikne Ome�ISp�ciry� —�A..rL.J � 1. �u Yw no� w NreYW an� ONn �OI�Cb �o W W amp�np mmE? NO G✓ 1n ❑ 11 w+�n b ItC �n Ne �CIuOiPlion Ceen remOVW � NO ❑ Yn ❑ 2. Ar�YaUlaleEloN�Ipn�I�apd�unlcbae�lMnu[onCrousin? 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I.IFUn�.meoi.pq�unr.�eme. �isr.wL 7. /itiC_:J �II �EOO��.lol �lOOplin PorMb ONy) I Pefi]erceollaNer�ilCttufM.atla:�� LQ«�°� Bihncb<eolln�er�5inemlank�«M) "'S^' (p) FWmaWMnemeal�OG�^��^+ONe� P/J�L �' �// _ , QIlGCOIed.11t1A00p4veG]rMbONy�Cl' a�asa� _ Rniaerce d motner (il cewuM. w�bn) � D�� ��"�p BiMplaca o� mou�n ISUU n �w�pn ceunvy) _�S: ^� •CKNOWLED6MENi I ac�no�IMqe Wt 1 n�ve rtcervM N!wrtulion nL��tlMO dM��Wa cCmmun1u01a OWtuf II��I�re��awllYVanSmitllC.\M�Gf�ol e1���iteflwlMrlNfN��GVMf/�IDSIMV�W �mmum a.r :�ry •v^aromq. ��( .{f(�-�� Sqivlvrad�pvMUnl �' � '� ' - ' �������— m..eo.a.o Wc.m i,ea oeisnea �o...�h�s er wm o..wmuuan e. ue^.:un io �e.ee.. �ctnw4C�nent peuuu ol eNigieua W4elf. CkK ol Coun a�e SI�ba1l.Mlam � Ifvev/�flirmNt�ObNlwmtlbn4�Hn counbWGwzn 1 '�' � �nmi'!c��"'u°"'��rw�rwwn�c�. sy�„ .k o7u�sea- ,Un.riv7p , r+e. �aa�m p $.�pul�peO �nE ��wor lo Lelwv me Nlf � Oay ol � 19_Lr ,p - OP ,�'l.i...,. Cen o� u» Gimm c�rcW� coim LONSENi OF f�FENTS, F/�HENi, Ofl GU�FOI/�N wn �ne oermis ortnn aoo�iant noeEy 9�•e wmem b.lnia m�rtl.pe.11 onyone w�enl �Nm. mbbeu.eJr.nm.bmecon..mo�meomvwnmu�muaury _ suiemma�ena I y Gwnry ol 1 Ft�Mt ID � MotM� ID • SuOfcriCp �M a�orn ta Celore me tNf _ Ury ol 19_ CNn COMFLETE IF MARPIACE LICENSE ISSUED BY OPDER OF COUNT. A marriage license having Eeen remsea m ma aoove namea varuea, �ne County Coun, by wrilten order issued end IileE in authorizea enE directa I�e issuanca ol e merriage license to the a�ova nameG partles. RETURN OF MARRIAGE LICENSE AND bfARRIAGE CERTIFICATE I cerGfy that thue was filed in my omce a memage lirense issued 6y the Clerk of the Cixuit Court of Ci6son Caunty, (ndiana, defed �; / 94S , e�utnharizing the marriage of ��� �-�""""� end �ZL"t� .7 .ClA� ,! r--' , ( furt':lce 'r�fy thal � e f 11� owing�ne �'ege certificate w�es filed in my o ce: 9` /�� f .l1niLLH X1n.f�Ct�LI (n �e rer ifY that on (datel, et�, L .I in �,�.in-„n County, lndiana, " � of�^'�'� - Count�; y��i =�-� (stste), end of ,i9 ��'� County; .� i�-�+ (atetel e'ere married 6y me as�7 authorized under a merriage license Ihet was issued 6}• the C1erk of the Circuit Co rt of Ci6 on Cou/q/ ty, yfn�d�in�n-�a�, d�at.Jed �^'�y-?�� � 4� �� � Signed by��-.^ �+'u"'�a�, p�- °—=a=� �a��a� designe/tion) h57ed and recorded in ecrordance with the laws of the State ot fndlena m �� � 9 %? (date). . 5��� /`-"e'4-� G=� Clerk �b�A.pp�n,��� . Ci6san Circuit Caurt � 13"�3�� f ' I t :