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GIBSON COUNTY AUOI7Ur No 80 �� ��
STATE OF INDIANA File 0907-h1L-000476
APPLICATION FOR MARRIAGE LICENSE ono�roe
HENDRICKS COUNTY DateofAppGnlion
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Name NICHOLAS RALPH IVERSON
Date of Birth 08117f78
Piace ol BiRh (State or foregn country) MINNESO7A
Residence Address 778 TATEAM DR County HENDRICKS
DANVILLE IN 46122
Previous Marital Status: NEVER MARRIED No. of Previous Marriages
Last Maniage Ended By: Date:
Date of birth verified by: D �Dri�isLic B�iC�Cat 0�
N 1. Are you now or have you ever been adjudged to be ol unsound mind?
If answer is'yes; has the adjudication been removed?
N 2. Are you retaled to Ne female appliwnt cbser than second cousin?
N 3. Are yau now under ihe influence of an alcoholic beverage?
N 4. Are you now under the influence oi a narcotic drug?
5. List of full names ot any dependent children
6. (a) Full name of appliwnYs father THEODORE RALPH IVERSON
(If adopted, list adoptive parents only)
Residence of father (il deceased, so state) INDIANA
Birihplace of father(state or foreign country) SOUTH DAKOTA
(b) Full maiden name of app�icanYs mother MARY ELIZABETH JORGENSEN
(II adopted, list adoplive parents only)
Residence of rtniher (d deceased, so state) INDIANA
Birihplace of rtwther (state or foreign country) SOUTH DAKOTA
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Name TRICIA KAY VENURELY
Date ot Birth 05127180
Place of Birth (Siate or (oreign country) INDIANA
Residence Address 778 TATEAM DR County HENDRICKS
DANVILLE IN 46122
Previous Marital Status: No. of Previous Marriages 2
Last Marriage Ended By: DIVORCE Date: 2008
Date of birth verified by: D a�mdsLic B�ihCert 0�4er
N 1. Are you now or have you ever been adjudged to be of unsound mind?
If answer is'yes; has the adjudication been removed?
N 2. Are you related to the male applicant doser than second cousin?
N 3. Are you now under the influence of an alcoholic beverege?
N 4. Are you now under lhe influence of a narcotic dmg?
5. List ot full names of any dependent children
6. (a) Full name of app�icant's father DAVID CHARLES VENDRELY
Qf adopted, list adoptive parents only)
Residence oi faNer (if deceased, so state) INDIANA
BiMplace of father1sGte or foreign country) INDIANA
(b) Full maiden name ot applicanYs mother SHARON LYNN LRTON
(If adopted, list adoptive parents only)
Residenreofrtqther(ddeceased,mstate) INDNNA
Birthplace of moiher (state or toreign counVy) INDIANA
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RETURN OF MARRIAGE LICENSE AND MARRIAGE CERTIfICATE
I certify that there was fiied in my office a marriage license issued by the Cleric of the Hendricks County, Indiana, dated
JULY 7, 2009 authorizing the marriage of:
NICHOLAS RALPH IVERSON and TRICIA KAY VENDRELY
I further certify that the following marriage certificate was filed in my office:
I, JONATHAN M HOOVER certify that on 07126/09 at DANVILLE in HENDRICKS
NICHOLAS RALPH IVERSON of HENDRICKS Counry, INDIANA
and
TRICIA KAY VENDRELY of HENDRICKS County, INDIANA
County, Indiana,
were married by me as authorized under the marriage license that was issued by the Clerk of the Circuit Court of
Hendricks
County, Indiana, dated JULY 7, 2009
Signed by: JONATHAN M HOOVER STAFF PASTOR
Filed and recorded in accordance with the laws of the State of Indiana on Jul 30, 2009.
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Signed \\ Clerk
Hendricks C nty Circuit Court
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