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<br />Department of Health · Vital Statistics
<br />STATE OF FLORIDA
<br />MARRIAGE RECORD
<br />TYPE IN UPPER CASE
<br />USE BLACK INK
<br />Thl. Iic"".. not valid unl..a ...1 01 CI.r1<,
<br />Circuit or County Court. app.... th.rec~,
<br />
<br />(STATE FILE NUMBER)
<br />
<br />/ /11I1//111/11I1111I1//(11I11I11/1/1111111 lllll I11I1 IIII lilt
<br />2002095955
<br />
<br />J0ESD/2P1I/TT"AN... PASCO COUNTY CLERK
<br />02 14:16am 1 of 1
<br />OR 81< 4984 PG 1412
<br />
<br />02748
<br />(APPLICA TION' NUMBER)
<br />
<br />~ "'~' 1 GROOM'S NAME (Fi,S1. MIddle, LaSl)
<br />
<br />APPLICATION TO MARRY
<br />
<br />/~~~~
<br />:ta
<br />
<br />2 DATE F BIRTH (Momh, Day. Ve..)
<br />
<br />LINWOOD
<br />38 REStDENCE. CITY, TOWN. OR LOCATION
<br />36624 SR 54 W
<br />ZEPHYRHILLS
<br />Sa BRIDE'S NAME (First, Middle, 1.1$1)
<br />
<br />EARL
<br />
<br />j3b ;:;:
<br />
<br />SHOREY
<br />
<br />I 3c STATE
<br />
<br />IFL. 33541
<br />I 5~. MAIDEN SURNAME (If Cliffe",nt/
<br />
<br />05-06-47
<br />4. BIRTHPLACE (Sl.t" 0' FOreign Country)
<br />
<br />I ME.
<br />
<br />8, DATE OF BIRTH (Month. Day. Yea,)
<br />
<br />KAREN ANN MORRIS
<br />7a, RESIDENCE. CITY, T~ OR lOCATION
<br />3842, NEWCASE AVE
<br />ZEJ:>HYRHILLS
<br />
<br />VEENSTRA 06-11-59
<br />7- COUNTY 7c. STATE e, BIRTHPlACE (Slete or FO'#IIgn Count,y)
<br />
<br />PAbCO FL. IMl~HXGAN
<br />WE THE APPLICANTS NAMED IN THIS CERTIFICATE. EACH FOR HIMSELF OR HERSEtF. STATE THAT THE INFORMATION PROVIDED
<br />ON THIS RECORD IS CORRECT TO THE BEST OF OUR KNO~OGE AND BELIEF. THAT NO LEGAL OBJECTION TO THE MAIlRIAGE
<br />NOR THE ISSUANCE OF A LICENSE TO AUTHORIZE THE SAME IS ~ TO US AND HEREBV APPlY FOR LICENSE TO MARRV
<br />9. SIGNATURE OF GRO n.fuN ".me using bI_ ink) 10. SUBSCRIBED AND SWORN TO IlCFORE ME ON (DATE)
<br />
<br />
<br />06-05-02
<br />
<br />.... .
<br />
<br />
<br />
<br />JED PITTMAN, CLERK 01:' THE CIRCUIT COURT ~ BY
<br />13 SIGNAT RE OF BRIOE (Sign full n'lIne USJnIl blltCk Jnk) 14. SUBS
<br />~ vY\~
<br />
<br />SEAL
<br />
<br />JED PITTMAN,
<br />
<br />u.
<br />
<br />~ BY
<br />
<br />06-05-02 06-09-02
<br />2Ob, TITLE JED PITTMAN, CLERK
<br />D THE CIRCUIT COURT
<br />CERTIFICATE OF MARRIAGE
<br />
<br />2Oc, BY DC
<br />
<br />SEAL
<br />
<br />KRG
<br />
<br />SEAL
<br />
<br />I HEREBV CERTIFY THAT THE ABOVE NAMED GROOM AND BRICE WERE JOlNED BV Me IN MARRIAGE IN ACCORDANCE WITH T>iE lAWS OF THE STATE OF FlORIOA.
<br />2i-oATe OF MARRIAGE (Montn, Day, Yell') I 22 CITY. TOWN, OR LOCAnON OF MARRIAGE
<br />I
<br />'.) i . iJ - (j 'J-... __ i Z, f'1... . .' I,; lIt -::/1(.;"
<br />23.. S. IGNATUR{;..OF PER)lON pERFORMI~ CEJjlEMONY (u. ~t:. ink) I '23c, ADDReSS {Ol~ performing ceremony}
<br />.... ,.,~, / A . ',_.~ .;,' /' --" :}") ".A" C I, ~ ...',;.- '~I." .~ C; .....'1 C h' r,
<br />" ~ /' .:""""" ~'v . ;>.."...:.----, .., I..' /, .., ',. ..;:) ::J'i.,.. '"
<br />23b, NAME Al'lO TITLE OF PERSON PERF"ORMING CEREMONv 24, SIG NATUR . W1TN€.S"T~CEMONY (Use black ink)
<br />(Df'noI...,"ornp) I ~ .,./ /' _____~ .,--".
<br />i-..L' ~ ~,---
<br />CHARLES W. THRASHER .. ~! '25 j~'1b~E o.~ T <' EMONY (Use blllCk ink)
<br />Notary Public, StaIB of "lor/da . !..-- L (.. \ "\ 'U lex.. ~ }~,.xl
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF PASCO
<br />THIS IS TO CERTIFY THAT THE FOREGOING IS A
<br />TRUE AND CORRECT copy OF THE DOCUMENT ON FILE
<br />OR OF PUBLIC RECORD IN THIS OFFICE WlTJ:i.SS MY
<br />H/o\ND AND OFFICIAL SEAL THIS ~l~AY OF
<br />~2&o~
<br />JEJ PITT A~CLE~T COURT
<br />BY L-:-. DEPUTY CLERK
<br />
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