Marriage Certificate - Willis, Peggy L_4/18/2017 Form Prescribed by Indiana STATE OF INDIANA Number: 2015-0000159
State Department of Health
Under Authority of Certified Marriage License
IC 31-11-4
Gibson County
APPLICANT 1 APPLICANT 2
Name GARY D WILLIS Name PEGGY L BOTTOMS
Birth Date July 26, 1945 Sex Male Birth Date September 07, 1946 Sex Female
Residence 2915 S 850 E Residence 4999 S STATE RD 57
Oakland City, IN 47660 Oakland City, IN 47660
County of Residence Gibson County of Residence Gibson
Birth Place Indiana, USA Birth Place Illinois, USA
Dependent Children Dependent Children -
None None
Parent 1's Name IRA WILLIS Parent l's Name LOUIS WARD SCHAFER
Parent l's Residence Oakland City, IN 47660 Parent l's Residence Francisco,IN 47649
Birth Place of Parent 1 Indiana, USA Birth Place of Parent 1 Indiana,USA
Parent 2's Name LOIS IMOGENE WILLIS(FICKLIN) Parent 2's Name HELEN LOUISE SCHAFER
(MATHEWS)
Parent 2's Residence Oakland City, IN 47660 Parent 2's Residence Francisco, IN 47649
Birth Place of Parent 2 Indiana, USA Birth Place of Parent 2 Illinois, USA
MARRIAGE INFORMATION
Marriage Date Saturday, August 15th, 2015 Marriage City/Town Francisco
Officiant Name MATTHEW P MALIN Marriage County Gibson
Officiant Title MINISTER Marriage State Indiana
License Issuing Clerk Jim Morrow Marriage Country United States
•The information above m e is a true and accurate copy of the information on file with the Cleric of the Circui;Court regarding the
Application Marriage and the Marriage License issued by thisoui1ty on July 15,2015.
Clerk of the Gibson Circuit Court, Gibssonn Comity,Indiana,this 28th day of August,2015
,'
Clerk —_-_-
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