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Marriage Certificate - Bent, Kimberly M_1/2/2015 Form Presaihed by Indiana STATE OF INDIANA Number: 2014-0000065 State Department of Health Under Authority of Certified Marriage License IC 31-11-4 Gibson County APPLICANT 1 APPLICANT 2 Name WILLIAM HR BENT Name KIMBERLY MARIE SCHMITS Birth Date November 26, 1982 Sex Male Birth Date January 08, 1992 Sex Female Residence 5409 E 575 S. Residence 5409 E 575 S Fort Branch, IN 47648 Fort Branch, IN 47648 County of Residence Gibson County of Residence Gibson Birth Place Indiana, USA Birth Place Indiana, USA Dependent Children Dependent Children CHLOEE BENT,ALTON W BENT None ; Parent l's Name KENNETH WILLIAM BENT Parent l's Name TIMOTHY LANE SCHMITS Parent l's Residence Indiana, USA Parent l's Residence Indiana, USA Birth Place of Parent 1 USA Birth Place of Parent 1 Indiana, USA Parent 2's Name JENNIE LYNN BENT(LEWIS) Parent 2's Name KATHY MARIE SCHMITS(STONE) Parent 2's Residence Indiana, USA Parent 2's Residence Indiana, USA Birth Place of Parent 2 Missouri, USA , 1 Birth Place of Parent 2 Indiana, USA MARRIAGE INFORMATION Marriage Date Saturday, May 3rd, 2014 Marriage City/Town FRANCISCO Officiant Name JUDY AMM WILLIAMS Marriage County Gibson Officiant Title PASTOR Marriage State Indiana License Issuing Clerk Becky Woodburn Marriage Country United States The information above is a true and accurate copy of the information on file with the Clerk of the Circuit Court regarding the Application for Marriage and the Marriage License issued by this county on April 24, 2014. Clerk of the Gibson Circuit Court,Gibson County,Indiana,this 2nd day of January,2015 — "Sivients. Clerk