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HomeMy WebLinkAbout03-05-07 . . MARRIAGE RECORD . Appl No. 2007-00102 1. COUNTY ISSUING LICENSE 2a. WHERE MARRIED-CITY, BORO, TOWNSHIP 2b. COUNTY 3. DATE OF MARRIAGE (Month, Day, Year) CUMBERLAND 4a. NAME OF PERSON PERFORMING CEREMONY 4b. TITLE 4c. ADDRESS OF PERSON PERFORMING CEREMONY (Street, City or Town, State, Zip Code) GROOM BRIDE 5. Full Name MOORE BRAIN DAVID 14. Full Name FOXX SUSAN B Maiden Surname 6. Mailing Address 30 NORTH 36 STREET APT 1 15. Mailing Address 30 N 36TH STREET CAMP HILL PA 17011 CAMP HILL PA 17011 . 7. Residence: CUMBERLAND 16. Residence: CUMBERLAND a. State PA b. County a. State PA b. County c. Location c. Location (1) City of (1) City of (2) Borough of (2) Borough of (3) Township of HAMPDEN (3) Township of HAMPDEN 8. Occupation 17. Occupation DRIVER STOCKPERSON TRUCK 9. Date of Birth Age roo Birthplace 18. Date of Birth Age 119. Birthplace 5/30/1978 28 SPRINGFIELD MO 12/07/1965 41 PEORIA IL 11 a. Number 111 b. How and When Dissolved 20a. Number 120b. How and When Dissolved of Prior 0 of Prior 0 Marriages Marriages 12. Cause(s) If Divorced 21. Cause(s) If Divorced 13. Education (0-12) I College (1-4 or 5+) 22. Education (0-12) I College (1-4 or 5+) I 1 03 12 I 01 12 I Date License Issued (Month, Day, Year) I~ate Report Sent (Month, Day, Year) I Signature of Clerk To Vital Statistics: Given and Surname of Father Given and Surname of Father MOORE JAMES M MOORE MICHAEL A Given and Surname of Mother Given and Surname of Mother MOORE ANITA L MATTERN ELEANOR M aiden Name of Mother Maiden Name of Mother HENRY RIES Residence of Father Residence of Father DETRO! T MI DECEASED Residence of Mother Residence of Mother DETROIT MI WENONA IL Occupation of Father Occupation of Father MANAGER DECEASED Occupation of Mother Occupation of Mother HOMEMAKER BOOKKEEPER Birthplace of Father Birthplace of Father WENONA IL Birthplace of Mother Birthplace of Mother LACOM IL Is applicant afflicted with any transmissible disease? Is applicant afflicted with any transmissible disease? No No Is applicant now under the influence of any intoxicating Is applicant now under the influence of any intoxicating liquor or narcotic drug? No liquor or narcotic drug? No Relationship of parties making this application, if any. NONE We, the undersigned, in accordance with the statements hereinabove contained, the facts set forth wherein we and each of us do solemnly .swear are true and correct to the best of our knowledge, information, and belief, do hereby make application to the Clerk of the Orphans' Court of e above County, for a license to marry. .d C ~ ~ 'J ~rtv~~ Signature of Applicant Signatur of plicant Sworn and subscribed to before me this 5th March A.D. 2007 Filed March 5th 2007 day of GLENDA FARNER STRASBAUGH (Clerk of Orphans' Court) wX~OOJq'.'lt)1!1.lit!~ (SEAL) License Issued January 4th My Commission Expires 2010 No. 0000102 13 I J't1 , S,(; 410....Y6 f -3~27 :;'56-66 S-bll] ,---, ~ ..J <( I- 0 I- Q) Q) u. ~ c: :J 0 () "C c: ..- C'l llS Q) - ll) C'l 'S; f1l ..- C'l c: l- I- llS Q) "C ~ () () () ~ ::J <( <( .lI: '- Q) C3 '0 Q) '- :J a; c: Cl i:i5 "C ~ u:: (lV3S) (e:l!Isnr 1Ol-lIS!Cl JO (~noo ,SU811dJO 10 ljJelOl (eO!ISnr IO!JISICl JO (~noo ,SU811dJO 10 ljJelOl 'C'V (lV3S) 'C'V lO,(BP Silll 'ew eJoleq UeA!~ lO,(BP Sllll 'ew eJOleq UeA!~ 'eflB!JJBW P!BS Olluesuoo ,(qeJell pUB 'eflBl-lJBW PiBS Olluesuoo ,(qeJell pUB 01 P!BS ,(w 10 aflBl-lJBW 01 P!BS ,(w 10 aflBpJBW pepUelU! elll 10 pewJoIU! ueeq eABll IIBlll 'eflB 10 SJBe,( pepUelU! elll 10 pewJoIU! ueeq eABll IIBlll 'eflB 10 SJBe,( MOU S! OllM MOU S! OIlM .- IB flu!PISeJ IB flu I, 10 elll WB 1 IBlll 10 elll WB I IBlll ,(j!~eo ,(qeJell op ,(j!lJeo ,(qeJell op IB flu!PISeJ 'I IB flUfP!SeJ 'I Q.1l?<<t .10 QIJg~ l? JO alll?J.1.1l?1if agt Ot tUa~uo~ >tJ91~ P91!~ '00'00 ~$ 10 wns elll ked pUB l!ejJoI IIBlls 10'1 S!lll ,(q peqposeJd eW!l elll U!lll!M >IJelO PIBS 01 elBO!ldnc ellll!WSUBJI 01 esnleJ IIBllS ollM uosJed JelllO JO 'eo!lsnr IO!JIS!C 'Jels!u!V\! ,(UB pUB S,(BP uel U!lll!M ,(junoO S!lll 10 jJnoO ,SUBlldJO alii 10 >IJalO elll 01 pauJnleJ pUB palloBlep aq 01 S! alBO!ldna alii pUB 'papJBW ,(jJBd alii 01 U9^!6 aq 01 S! alBo!l!jJ90 IBU!6PO 9111-310N 90U9p!Sa~ IS9!Jd JO '90!ISnr 1O!JIS!a '19dSOE) 911110 J9IS!U!~ 'ON 'e!Ue^I^SUUad 1.m0~ ,SUelldJO 9111 10 >tJ91~ 9111 ^q p9nSS! 9SU90!l 1l1!M aOuepJoooe U! 96e!JJew U! pal,un 9W ^q 9J9M pue Ie' "a'v' 10 ^ep alii uo lelll ~!lJao ^q9J911 (eWllU IU!Jd JO edAll 31 VOl1dna