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Marriage Certificate - White, Tracy_6/1/2011Form Prescribed by Indiana State Department of Health Under Authoriry of IC 31-11-4-4 STATE OF INDIANA Certified Marriage License Gibson County Number: 207 7-0000080 GROOM BRIDE Name RICK A SEIBERT Name TRACY l WHITE � Birth Date May 05, 1955 Birth Date September 10, 1957 Residence 116 S MAIN P O BOX 102 Residence 116 S MAIN P 0 BOX 102 Patoka,IN 47666 Patoka,IN 47666 � County ofResidence� Gibson-. , County olResidence Gibson Birth P/ace Illinois, USA Birth Place Indiana, USA Dependent Children Dependent Children None - � None Father's Name ARCHIE A. SEIBERT Father's Name ALAN K. HOUSE Fathers Residence MT CARMEL, IL Fathers Residence Princeton, IN 47670 Birth Place ol Father Illinois, USA Birth Place o/Father Indiana, USA Mofhers Name GERTRUDE W. SEIBERT Mofhers Name JANET R. HOUSE Mo[hers Maiden Name BOLDEN Mothers Maiden Name SMITH Mothers Residence MT CARMEL, IL Mofhers Residence Princeton, IN 47670 Birth Place ofMOther Illinois, USA Birth Place ofMother Missouri, USA MARRIAGE INFORMATION Marriage Date Monday, May 9th, 2011 Mairiage City?own PRINCETON O�ciant Name Robert J Hurst � Marriage County Gibson O�ciant Title Mayor Of Princeton Marriage Sta[e Indiana License Issuing Clerk Becky Woodburn Marriage Country United States The infortnation above is a true and accurate copy of the infortnation on file with the Clerk of the Cirwit Court regarding the Application for Marriage and the Marriage License issued by this couniy on May 9, 2071. Clerk o/fhe Gibson Circuit Court, Gibson County, Mdiana, this 17th day olMay, 2011 S�AL �¢uF� !.[Jo..a� Lkn.r�.- Clerk \