HomeMy WebLinkAbout00-04294
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USUAL Rt;S10ENCE _STl'oE'ET ADDRESS
7918 Armstron
Zo,
COUN1'Y
andott
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~-NOV 07 1988
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KANSAS STAnt Dt:PARTMENTOF t(~L.TH AND ENVIRONM1':NT
VrrAt. :;tTAt'fs,tCS ~ ---
CERTIFICATE OF DIVORCE OR ANN(jLMENT
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Lemans
Cft'v: TOWN Otl,I..0CA1'lON,
tlIRt'KI"UlC!i '5~1" ~ /1"'16" tDl/."rl')'
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lb. 1{
STA.TE
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F'~Sl'
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MIDDL.E
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", Yvonne Carol Leman ke
USUAL REsrDENCf 5TI'I'EI!T ADDRESS
I C";-;"'.J'orm Of' LoCATION
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Ol,
NA
ST...TE-I/f.."t'..t.-::;-......."'t........,.,.J
b, Osdor
COUNTY
l"LACE or: THIS "1AARfAGE~CITY
~BB-alaI2Z
SrA'l'1I!: FIL.E. NUMDEA
L.ll..!,,.
it:v
INSIDE City LIMITS
l~Yf1S(JrNo~
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M;'IOE~ NAME
50,
msmE CItY UMrTS
tSi>>dlv Yes or No)
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unknown
DATE OF tslRTH .Jlo.. D~~. y..j"
f~1 'PLAtE/SI..lr ur tl1~/IfI C<W"l'I'~1
''T: ~-NA
West:
." Denmark 9b, NA ",NA
NUMBER OF CHILDREN EVER BORt~~"LjVf OF THIS MAARIAGE CHILDREN UNDi'Pi 18 IN THis 1I''''~I'i.'y I~;'~ i
'.:iP"<:I(\' I"
III, one . 1 Ill. ' - one .- ~
ATTORN~Y FOR PETITIOt>JEi'i-t>JA.Mt: 'l>.DF '''P""U :.10.0 RESS ~1'"q~'p_~~. ~.l";O. NO,
13..
Marcus B. Potter, jr
MDf\th
Do'
"', 831 Armstrong cCUnsas
TYFEOFOECREC-~tiI'lAHN1JU,tf.NT
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14b.
I I;tlhfyIMllhell\lrTllge
O'(~Mlo"n.lmlClotrfOfll
141. WilH:I,uol.lldlll'i
COUNTY OF OECI'I.EE
t4d. Wan
SIGNATURE 0,. Cf.RTI
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Yfar
9 15 BB
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Ll':' Ti 0;:- Tl-llS' M~;:;Rl.ll,GE
I 'Jllt.UQ), 1'r.J
>,", 12/24 84 ta,
PETJTIONEPl_HU5BA~O.-WIFE. BOTH. OTHEPl !Sp~c-l'H
OA iE COt.l'LE SEPARA.TeD
IMD"D{,J-,)'r)
NA
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husband
C1TV OR TOW~
mn
City, Kansas 66101
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'~frtC("Ol'bi='~Ii::'iAt;_
14, Deputy Clerk of the District Court
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A00777530
This is a true and correct copy of t1ie official record on filein the Office of
Vital Statistics, Topeka, Kansas,' r;ertified on the date stamped below,
f,(~ ~. ~,
'[~meA,. PhilliP~
State Registrar
Office of Vital Statistics
Department of Health & Environment
ZllD JUN 20 rM"'1;t!1
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It is in violatiop of KSA 65-2422d(g) to "prepare or issue MY certific:}te which purports to be an
original, certified copy or copy of a certificate of birth, death orfet31 death, except as authorized
in this act or rules and regulations adopted under this, act."
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CER'fIFIED COPIES WILL BE PRODUCED(j,N M:ulJn.C(jUOR SECURITY PAPER.
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.gl.trallOl1 Di". No.~u<?___":':._'::'
CERTIFICA TE OF BIRTH
Vital staW&s - Stale Board of Health 0 2
South Carolina Birth No. 139 _ 6 5 J 4 51
I ~. U:;iJAL Rt:.SWt;N<..:.t: Of' M(Y.fjifii(~ dooPt motbn- live?)
.. STATE b. COUNTY
S. C. Richland
l c. CITY, TOWNCo;=~ON
I d, STI\EET ADDIlKSS
960 D 1.0 Circle
.' IlKSIDENCE IXSIDE CIIT LlWTS? I
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tal
egJ..trar'.No.._._____
. PJ_.,U;F. OF' .!u:r!J]
., COUNTY
R1.chland
~. TOWN. or LOCATION
Fort JacJcaon, ". c.
.. NAME or (II _ to boapItal. p,. _ addIfta)
IIO$PITAL or
IN'ITrnrrrON 17. S. So
-;r.-I! PLACE Ot' IIlIlTH IXSIDE ClTT l.D(
YES
YES
f. IS IlESID
A F AIlM?
YES
'cr ON
lTn>o or pfDI)
l'Y0DDe
carol r
51>. IF TWIN OR TRIPLET. WAS ClIJLD 1lOR.-'; , e, DATE
OF
1ST W 3D n BrRTH
!l.1.,;.,ulb
OCT
4
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MU
(At ...... 01 ohio bU1b)
Be
10. BIRmPLACE (5.... a<
'PATIOS
lIb, Iwm OF BUSINESS OR
ISDUSTRY
tB
2S
TEAM
West VirgjwfD,
Marion
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Platz "ft"
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J 8, I'I\EVJOUS DELIVERIES TO McrrnER
(Do NOT lDclud. ohio birth)
L How maD)' I b. H~ many OTHER I c. Ht)'W maD7 frtaJ deetb.
O'THEP. ehlld:rn dllldn-n..-ett barD .uh'"e' (It.futn bQrn ~ at AA'"'f
:lJe an...- livin.? I but arf: ttOW dad? ! time after ~.Aioa)?
1 i 1 - 0
17., MOTHE!l'S M,"USG ADDRESS
2
14, A {'\I'2; oj tb= 115. Bl Ge~ '" 10m.., -,
11. I In" ~ ttw ..f....~ _ Ihh.....,. c:tan.rs birth c:erti6eate.
IlDd he! II to.~ ~
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IS .......,_
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tlw thit c.b' 1 :7 ~ ~ ~ M,D." ).fXlwife n ()tbe., 0
w.. ,bora a!1'YC' CD _ liA '-' __
"" do.. ....rd IBb, /J)DRESS . . B.6RlUJln.C>H Ilk DATE SIG:o.'ED
1':w! 2:00 u. S. ~ iio~tal, i;';r' :fA~b1:~~..(j~tobeI' 1965
.. DA'l'E RECD. BY LOc:AL IlEG. 20, REGlSTIIA 51 OJ.!. - )1; -4
,/ CJ - ?- 6 ..s-- //7. .
Same as above
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
:
Ue..u,,, LQ i :
f:::;. '\<\ C-V\ oS \.z..-e :
Plaintiff :
: File No. ()(). '1.29<( ~ /VA-
vs. : IN DIVORCE
:
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Defendant :
NOTICE TO RESUME PRIOR SURNAME
Notice is hereby given that the Plaintiff/Defendant in the
above matter, having been granted a Final Decree in Divorce on the
\S day of s,Q 1i(\Q.\)J.~r , 19 't~ , hereby elects to resume the
prior surname of c..OO~'<-J , and gives
this written notice pursuant to the prov1s10ns of 54 P.S. S 704.
DATE:(')(~, :.L~.t:D ~~\\~~
'""" ~ ~'Ign~ure
c. CO~~
COMMONWEALTH OF PENNSYLVANIA:
: SSe
COUNTY OF CUMBERLAND
/l
On the 'J.,C;tf day Of~..,., I ,--:rg-~, before me, a
Notary Public, personally app red the above affiant known to me to
be the person whose name is subscribed to the within document and
acknowledged that he/she executed the foregoing for the purpose
therein contained.
In Witness Whereof, I have hereunto set my hand and official
seal.
PATRleili', ',TTO, Nota~/'~bIiC
Carlis!eBoro, Cumberland County
My commls~lon Expires December1?, 2001
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