HomeMy WebLinkAbout09-21-06
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Appl No. 2006 - 00915
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MARRIAGE RECORD
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1. COUNTY ISSUING LICENSE 2a. WHERE MARRIED-CITY, BORO, TOWNSHIP 2b. COUNTY 3. DATE OF MARRIAGE
CUMBERLAND (Month, Day, Year)
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 GRANOFF MARK S 14. Full Name BOLLINGER STEPHANIE A
Maiden Surname
6. Mailing Address 3219 S PORT ROYALE DR APT G 15. Mailing Address 3219 S PORT ROYALE DR APTG
I FORT LAUDERDALE FT LAUDERDALE
7. Residence: BROWARD 16. Residence:
a. State FL b. County a. State FL b. County
c. Location c. Location
(1) City of FT LAUDERDALE (1) City of FT LAUDERDALE
(2) Borough of (2) Borough of
(3) Township of (3) Township of
8. Occupatio1;ALES 17.0ccupatiofh.cCOUNTING
9. Date t Birth Age r O. B~lace 18. Date of Birth Age 119. B~ace
10 18/1977 28 P HILL PA 2/16/1979 27 P HILL PA
11 a. Number r 1 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) ; College (1-4 or 5+) 22. Education (0-12) I College (1-4 or 5+)
12 I 04 12 I 04
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Date Cf1sH ued (Month, Day, Year) IDate Report Sent (Mq~ O'l Year) ISignatWJJ;k ~}\
frfJ To Vital Statistics: ~ , tJ l/1 ,,__v ~
Given and Surnl me of Father (3iven and Surname of Father 7J
GRANOFF J STEPHEN BOLLINGER D TIMOTHY
....... Given and Surname of Mother Given and Surname of Mother
LONG MARY E BOLLINGER DORINE A
.......,v1aiden Name of Mother Maiden Name of Mother
YECKLEY DONNELL
Residence of Father Residence of Father
233 N 24TH ST CAMP HILL PA 2316 KENT ST CAMP HILL PA
Residence of Mother Residence of Mother
LINGLESTOWN PA 782 ALLENVIEW DR MECHANICSBURG PA
Occupation of Father Occupation of Father
INSURANCE ENGINEER
Occupation of Mother Occupation of Mother
TEACHER PA STATE EMPLOYEE
Birthplace of Father Birthplace of Father
HARRISBURG PA BALTIMORE MD
Birthplace of Mother Birthplace of Mother
HARRISBURG PA HONOLULU HI
Is applicant afflicted with any transmissible disease? Is applicant afflicted with any transmissible disease?
No No
5 applicant now under the influence of any intoxicating Is applicant now under the influence of any intoxicating
quor or narcotic drug? No liquor or narcotic drug? No
,elationship 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
he above County, for a lice to marry. "
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September
21st
2006
day of September A.D. 2006~
GLENDA FARNER STRASBAUGH ~I+- r~.\). b
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January 4th 2010
My Commission Expires
(Clerk of Orphans' Court)
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)rn and subscribed to before me this
21st
,se Issued
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