S211990 Motion For Judicial Notice ISO Oppn To Writ - Part 2

STATE FILE NUMBER
CONFIDENTIAL
LICENSE AND CERTIFICATE OF MARRlAGE
MUST BE -LEGIBLE hlO ERP,BURES, OR OTHER ,1;.LTER.!:l,T10NS
USE DARK INK ONLY LOCbL
1A;'fIRST [-t.;ME ,lB. MJDDLE
I
I
!C, CURREt>IT UI..ST 10. Nfl;MEAT,BIRTH (IF 1C)
2, DATE'OF B!RTH (I,A 13' 8TATEiOOQI-ITRY OF B'!RTH!4. '#PREv, M.
8. ADDRESS r. CITY
1-0P FULL BIRTH E OF
5A. LAST MARRL;GE/SRDP EI>lDED 108, DATE EI"1DED (hI, Mf.DD1CCyr)
I .
QDE.\!lJH lJDISSO OJ:NNUl:MENTDTER,M"SRDPONIAI
18. 19: ZiP CODE
11GB. .sTATE OF BIRTt4 OUTSI-qE U.S. EN
(
,.
111';. FULl.. OF QTHERfPAHEI-IT :.11'8. 'STATE o.F BIRTH.(IF OUTSIDE U.S. ENTER COUNTRY)
: .h',""
:128,MIDDLE'"
,
,
1.3. DATE Of 81RTH ,(I\'llMDDfCCYYl)14. 8IF[TH 1'5. PRE'.'. 16:.t" LAST ,:EJJDED BY.: [1:88. DATE EI"DEO (MM.lODlCCYYi
", ' 1
DDEA.1H 0 DISO 0 !iI'';1
12C. CURREhlT LA.ST
17,ADDRESS
21ft.. FULL BIRTH N.!;,M E OF F'A
12D.I..AST AT BIRTH (fF.
rS.-CITY .,rB.'STA.TS'COUNTRY 110.ZJFCODE
1:2\8. 8T,.;TE OF BIRTH OUTSfDE U.S. ENTER COU!'ITRY)
I
I.
24A. FULi- BIRTH N.!l..ME OF MOTHERfPARHH 1128,8T.::.1E OF SfRTH QF OUT8fO \J.S, f:'blTE;P' CCi'UNTRYj,
I
,
WE, I HE Ul\lDER8IGNEO, CURREI'frLY U\!:I"G TOGEI HER A.S SP9USES, DE,CLAR.e UNDER PERJURY UI"UER THE L.!>.Vy'S 'OF THE StATE OF CALlFQRNIA THATV.fE .!;,RE
P.I'JO THAT THE FOREG01NG 18 TRUE AND CORRECT TO THE '8EST OF OUR t<I\lOV,iLEDGE Atm BELlEF'. WE FURTHER THAT tJO LEGAL
Q'B.JECTIObl TO THE MP-,RRl..;GE, 1'-J6R TO THE OF A UCENSE IS l<i"OV',IN TO' US:-ir,t)=:-AO':NOINLEDGE RECEIPT OF THE REQUIR,ED BY F,';hlIL'r' CODE
SECTION 3513 A!4D HEREBY .t"PPLY FOR A CNJFIDENTl.A.LUCEN8E AbID CEF;TIFIC.';TE OF
2: OF PERSClhl LISTED FIELDS lA-1D ! OF F'ERSON USTED IN FIELDS 12A12D
I., T'rlE UNDERS!(;J-l,EO, DO HEREBY CERTIFY THAT THE f.6CiVE7 Nt'.ME:D PARTIE'STO 8E Itll,ll.RRIED HP-.VE PERSbt:::.ALLY APPEARED BEF.ORE ME AND PF:OVED TO IvrE 01": TH!::: BASiS
OF SAnSFACTORY EViDEI"CE TO BE THE- PERSONS CLA.IMED, OR THAT THE PERFORMING THE CEREMONY I-l.;S PERSOf>lALLY APPE,;RI;D SEFORE ME AND PRESENTED
!.. AFFIDAVIT SIGI'JED 8Y THE PARTIES TO BE i\<\.';RRIED TH..q:pJ-JE OF: BOTH OF THE P.4.RT1ES ARE PHYSIC.';LLY TO EXPL';lNING THE REASOI-.J8
THE REF OF( IN ,;CGORDANCE WITH F.::.II1ILY CODE SECTION 502. THE PARTIES FIJRTHER DECLARED TH."T THEY' MEET ALL OF THE REQUIREMEI"!TS OF THE LAW, AND
P..;!D THE FEES PRESCRIBED BV LA.\N, .A,UTHORIL.e..TION p,i'lQ.UCEI'>!SE IS HERESY GIVEI>l TO /'.N'l' PERSON DULY AUTHORIZED TO A ItolARF;IP-.GE CE.REMNfJ'
mTHI!'J THE STATE OF CAUFORNJA, TO SOLEMNIZE OF THE A80VENAMED PERSONS TO FI',MIL'f CODE SECTION 500. NOTE: THE WlARF:lt..GE
CEREM0NY MUST T,t..KE PLIl,GE 1N THE COUNTY ItJ V\!HIGH THE LICENSE ',",(,".8 18SUED.;S IDE-hITIFlED IN ITEM BELOVV,
25A. ISSUE DATE Ol'lll1,iDDfCCYY) ! 258, EXPIRES AFTER I 25C. I-.lAME OF COUI-.lTY CLERK [250. SIGNATURE OF -CLERK OR DEPUTY CLERK
" .', I I" .
I I r BY)oo
25E. Iv\ARRlp,GE UGEt\lSE NUM.BER, J 1:>F. COUNTY Of ISSUE ,25G, MARRIP-.GE TO (INCLUDE ADDRESS):
, i
, I
I ,
, ,
26,;;". ST,.o..TE Qfr:;ALlF'QR!"!IA, COUNTT' OF; ,268. TYPED NA!'!1-E Df NOTARY. f 150. f.FF.lX NOT.t:RY
, ,
. ,
A .... T9. (OR AFF.lRfJE-D) B EF 0 : 26C. SIGN,/;TUF:E. OF NO:! ARY :
, i
BY l l
;
I, THE D!:::,CL.!:..RE UNDER PE1-.l.:'.LTY OF PERjuRY 'UNDER THE U;,\IVS OF THE BTl,TE Of THE ABOVENAMED PARiIES- \-,\{ERE JOIf'>lED BY ME iN
MARRl.A.GE LAWS OF THE STATE OF CALtFORNI.;. NOTE: tHE M.A,RRL.ll,GECEREMObIY MUST TAKE PLA.CE IN r'HE -C:OU!\rn' IN\,\IHICHTHE.LlCENSE VI!AS
ISSUED AS IDENTIF1E-D 25F ,Il,BOVE:
28E. ADDRESS, CITY, STATElOOUNTRY, ANCizip CODE
Of PERSON SOLE'MbHZING (TYPE OR PRINT CLEARLy)
I lTC. COUhlTYOF 1.1!,RRlAGE
I
,
28D. OFHCI.... L TITLE
,.
,
i 288. REUGIO'US t?ENOMINATIOJ'J (IF CLERGy)
,
,
1178. em' OF
,
I
YciABI!3t.J.I\TU.RE DF PERSON SOLE1l"d\J!ZING MARR1AG.E
27A. DATE Of MARRIAGE tMM!DDJeCYYl
HEW-MlDDLEAND LASTNAME OF PERSON LISTED IN 1A.1D OF ANY) fOR USE UPONSOLEMNIZATtON OF THE MARRIAGE {SEE REVERSE PORINF-ORMATlON)
.2SA.FIRST MUST13ESAMEAS1A I 29B.MlDDU: 12,fIC.LA'ST.
. I ,
U1.-.j:t

:z: <::( ii: ======
. 3Q.J1,. FIRST -MUST BE SA-ME AS 12A 1308. MIDDLE i 30C. LAST
z I I
COUNTY
CLERK
3l-A. OF GOUNTr OLERK 1.318. SIGN..e,TVRE OF CLERKOFi. DEPUJY CLERK
,
l
,31C. ,.'i,CCEPTED FOH REGISTRI;,TION
,
I
,
STATE OF DEPP.,RTMI;NT OF pU8Ue HEALTH. OFHCE OF VlTALR,ECO'RDS Y&1.23
85
AFFIDAVIT TO AMEND A MARRIAGE RECORD
NO ERASURES, WrlITEOUTS, PHOTOCOPIES,
oR AlTERATIONS
stATE FILE 8ER
oPUBLIC o o DECLARED
NlJM'BER
o NON-CLERGY
TYPEOR PRINT CLEARLY IN SLACK INK ONLY -1HIS.AMENDIVENT BECOMES A PART OF THE OFFICIAL RECORD
PART I INFORMArlON TO LOCATE RECOR[}-TYPE OR PRINT IN BLACK INK ONLY
tA. F1HST Nl:.fAE AS US:rED ON <?ERTlFI,C;tl,T.E IN. F1ELD 1,A,. 11.8. 11'l";oPLE NAMEJl.S. US1ED CEHTh-1CP,T:E, FiELD 1E.
I
10. CURRENT LAST AS LISTED ON MARRJA'GER'ERTlfJ(:ATE F1ELO 1C BtRTH iAST I\IP;ME, IF DIFFERENT fRQM FIE;Ll? 1C

APpE,RS
urJ (JF; GU".L
RfC9
RD

I
4C:. CURRENT LAST AS USTED ON MARRIAGE CERTlflCAT.E FJElD 12C : 4D. BlRTH U!:S;1 NAME, jF FROh('FIELD
PART II STATEMENT OF CORRECTiONS to MARRIAGE RECORD
5. FfEr.l
I;lUMBER TO, 8 E 6. INCORRECT II>lFOHMATl 0 NTH.:l;T APPEARS 01-1 aRIGNt.. L REC"ORD
C.QRRECT1=D
7. CORRECTED II\IFORMATI01J ,;8 IT Sf-!OULD p..PPEAR
LISTONE
ITEI\\PER
L1fiE
.
.
B.

FOR
COFFEC1iot1 f-----'--------------------------------------------
; Be, DATE SIGNEQ-MMfPDICCYY i9B, TlTlEiRELATliJh'8HIP TO F'A,9,T I
We, the undersigned, hereby certify under penatty of perjury that" we have personal knowledge of the above facts and th,at the
information giver above is true and correct .
lA, SIGblATURE OF tlRST PERS(;ol'<l
Ti>\fO 80, ADDRESS (STREET AND HUMBER, CITY, STATE, tiP CODE)

MUBTSIGI'I 1---------------------,-----------,-----------------------
1}4IS 1M. SlGN.:>.TURE QF SECONQPERSQN ; lUS.llRE!RELo\T1ONSHIPTO PERSQ.N{S) IN P,A.RTI i1'OC, D,A.TE
TO 'CORr;ECT I>-
AM!\F:FlAGE (------------------------'------------------"-- _
'RECORD 1OD. ADDf.'ESS (STReET AND I'JUIolBER, ern', 'ST';TE, 2lP 90DE)
STATEtLOCAL 11. QFHCEDf" STATE-OR LOCALttEGISTRAR.
..
1'2. DATE ACCEP1l'o 'OR REG'STRATiON
OF CAUFORNl:',. DEPARTI1iENT-OF PUBUOIiEALTK, OFFICE'OfVITALRECqROS
86
XViI. HISTORICAL MARRIAGE FORMS
The following pages contain the historical marriage license forms:
'" Version 01/01/2009
.. Version 11/2008
<> Version 06/2008 with overlay
.. Version 06/2008
'" Version 01/01/2008
<> Version 01/01/2006 (VS 117)
.. Version 11/2005 (VS 115)
.. Version 11/2005 (VS 116)
.. Version 11/2005 (VS 123)
.. Version 01/2000 (VS 117)
.. Version 01/2000 (VS 123)
'" Version 01/2000 (VS 122)
.. Version 01/1992 (VS 115)
" Version 01/1992 (VS 116)
.. Version 01/1992 (VS 117C)
.. Version 07/1991 (VS 24C)
" Version 06/1991 (VS 122)
.. Version 03/1991 (VS 117)
" Version 03/1991 (VS 123)
.. Version 01/1991 (VS 123)
.. Version 07/1990 (VS 123)
.. Version 06/1990 (VS 115)
87
XVII. HiSTORICAL M A R R ~ A G E FORMS = CONTINUED
G) Version 06/1990 (VS 116)
" Version 06/1989 (VS 123)
.. Version 01/1989 (VS 116)
" Version 01/1989 (VS 117)
.. Version 01/1987 (VS 123)
" Version 07/1986 (VS 117A)
() Version 01/1986 (VS 123)
.. Version 01/1984 (VS 123)
.. Version 06/1981 (VS 117A)
.. Version 08/1978 (VS 117A)
.. Version 04/04/1974 (Confidential Record of Church Marriages)
@ Version 04/1974 (VS 117A)
.. Version 09/1973 (VS 117A)
.. Version 03/01/1972 (VS 117A)
.. Version09/15/1961 (VS 117A)
.. Version 01/01/1960 (VS 117A)
Marriage Souvenirs
.. Version 07/01/2008 (VS 118e)
88
STATE FILE hIUIv',8ER
LICENSE AND CERTIFJ9ATE OF MARRIAGE
FORDENOMINATIONS NOT HAVING CLERGY
MUST BE LEGJ6LE -lv1jlJ<E I'JO ERASURES. \,\tlTTEOUTS, OR"OTHER AI,TERAT10NS
USE DARK INK OtlLY LOCAJ... REG NU....16ER
1A FIRST NP.j,'iE I 18.
,
I
lC LAST tD.-lASTNAII4E p,T BIRTH {IF DIFFERENT THAN 1c;)
6.PDDRESS 7. crry 8 STAlSiCOUhlTRY ILZ.lPCODE
: 108. STATE, OF .BIRTH {IF OUTSIDE u.s., EtHER CQU.NTRY)
,
10A FU.LL BIRTI-l NAME OF
2. DATEOi= BIRTH (MMlOD/CCY\') 3.. STA1ElCOUNTRY OF BIRTH 4, #PREV. Iv\A.RRIAGESlSRDP 5A.lAST ENDED By: (5B.DATE:EHDED {MM-vD/CC)'Yl
" I
o DEATH DDISSO .pml>lULMENJp iERMSRDP0 'NiAi
j 250, SIGI-lATUR,E OF CLER-K (oR DEPUTY CLERK
,
I GYp.
OF PERSON L1STEQ IN FIELDS
OF TH.t.l' VIlE.- ARE UNtlIA!:(HlED A1oJO THAT THE fOREGOING
THAT NO LEGP-J... Q8GfION TO THE MARRIAGE NOR TO THE
81' FNvllLY CODE SECTION 358 (-'lND f:\PF;LY fOR ,A LICENSE
120 NJ\lvlEAT BIRTH {Jf D1
.: 12B. t;1IDDLE
I
,
S\t;lP.IlE Y l,pPE.o..RED BEFORE ME pND PROVED TO M-S ON THE BAS1S OF
fILL THE REOUIREMEI'JTS OF THE LP.....,', JlJ-.JD H.....VE PP,IfJ THE FEES PRESCRIBED BY
PN["- CERTIFICATE OF MARRIA,GE FOR DENOMIN,Jo.TIONS H.... CLERGY REQUIRED
COMPLETED h/"Cl,RRtAGE LiCENSE TQ(lNCL1..!DE .ll.,DDRESS)
i$.CITY
23" SiGNATURE OF PERSON lIHED lIoJ FIELDS jA-1D
22A. FULL 81RTH t-lAl>1E ()F 1v',OTJ-lrER!PARENT
21A BIRTH NpN,1;: OF FATHERtP,.....REI-JT
25E. !'lUMBER
VYE., THE ,L,80VE..NPMED PART1ES, Ut-iDER . .y OF PERJURY UblDER THE LAWS OF THE OF THAT V{E VVERE J:'INeD IN M!.\RR1,ll,GE IN
P,CCORDAt4cE\;\'lTH tHE RULES ,A,NO ..,Of OUR SOCIETYOR DEN01.;lltJATIOloJ AND IN ACCOF::D,1.:J.JCEY.,.'ITH 'THE LAVyS OF THE STATE OF CALIFORNI,'),.
12C. CURRENT LAST
13 DA'J,EOFBIRTH (!"1INDC'!CCY1'i 14.STf,lFLOUt$'fOFBIRTrJ 15 #PREV MARRlAGES/SRDF'
o DEATH 0 01$80 0
17.J>'oORESS
I, THE UNDERSIGNED,"DO HEREBY Cl;RTIFY THI',T THE ABOVE
S.A.TISF p,CTr)RY EVIDEI-JCETO BE THE PERSONS HAVE D
LAVv, THESE REoUlj:{EM8oJTS HAVII'lGE-EEhJ MET. I HERE
N.JI) FOR THE ISSU,llJ'JCE' OF THIS LI ...
2oA. ISSUE DATE (MMIDDICC'(n ; 158, EXP1RESAFTEH
,
,
I/'/E, THE I..H,JOERSIGNED, DECUHE OF PEr-1.JJRY UNDER THE LlJ;,vVS
IS TR.lJEAi\lD CORRECT TO THE BEST OF OUR KroJO\'\lEDGE ,fNO SELl[F
ISSUAt<.lCE OF A. LLCENSE IS KNO\'\!l.J TO US. v.... 1: AC!,NQv\'LEOGE RECEIPT OF THE lrjf"f;;,
AND CERTIFICATE QFMP-RRIAGE FOH DENOMJroJ.",T IONS NOT t1P;v-'lt'lG CLERGY. . ''''
11A PJLL BIRTH OF MOTHERI?Aqa-IT
ID <;
:go

"
E oJ
d"-
20
02
08
uJ
"
17. StGNATURi:. OF PERSOt.J LISTED IN F'IBDS 1A.. 1D 2$. SIGNATURE OF PERSON LISTED IN FIELDS 12A'120
p.. ,..
--!oj." {29B NAIv\E OF PERSDIJ V\1TfJESS!NG l',1PRRIAGE (TYPE,OR PRiNT CLEf..4LY)
\ I
I 306.NAII,E OF PERSON \'\'lTNESSlhIG 1,1ARRlAGE (T 'WE o.R PRJNT CLEARL Y)
,
I
30C ADDRESS, CITY, STATEP')UNTRY. AND ZIP
30A. SIGtJATURE OF \'\nNE;SS.
vVE. THE UNDERSIG.NED,1:CL ER PENAllY'OF PERJJRY UlmER THE Ltl,VVS OF THE- STJl.TE OF CALlfORt;jjA. THAT We'vVC.RE PHi'Sl-r..A!..LY PRESEt'IT /l,T THE ty,t'RRlAGE
CERElvlOHY OF PER$OI>lS, THATVJEWITNESSED THE ABQVE-N.AMED PERSONS COMPLETE T!-IE MAAR\,Il,GE CEREMQNY, THAT 'THE q:-RElviONY OCCURRED IN
OING INFORI.....,ATION ISTR\IEPND CORRECT TO HiE BEST OF OUR: KNOWLED"GE AND BEliEF.
NEW"MIDDLEAND LAST OF PERSON LISTED IN 1A-1D{IF ANY) FOR USEUPON SOLEMhllZAllON OF THE MARRIAGE (SEE REVERSE FOR INFORMATION)
31A. FIRST- Ml../.STBE SMlEAS 1A (318, MIDDLE r31C. LAsT
, ,
,
NEWt-HOOLE AND LAST NAMEOF PERSON LISTED IN 12A.-12D (IF ANY) FOR USE UPON:SOLEMNlZJ:\.TlON.OF THE MARRIAGE (SEE REVERSE FOR, INFQRMAllON)
32A. fIR$T - MUSTBE SAME AS 12A I MIDDLE ,320, LAST
, I
lO('..A,L
P.EGlSiRAA
33A,. NAfJ:E OF tOCAl REGISTRAR- 1$3.8 SIC;NP-.TURE OF CLERK OR DEPUT\' CLER!.<
,"
I
I sse. o.tl,TS AGCEPTED FQR Rl=J?ISTRATION
I ""
'"
STATE Of CAI.JFQRNtA,.DEPARTlvlENT OF PU9;LICHE.AJ...TH. OfFICE OF VITAi... RECORDS. V&-11S--t01ro1l200S1
89
STATE FILE'(,lUMBER
LICENSE AN[) CERTIFICATE Of
DECLARATION OF MARRIAGE
1\'II.1.$T BE LEG:J8L,E - MAl-'. NO ERASURES, 'of'klITEGUT,S, OROTHER ,AJ..IERATIONS,
USE DARK INK ONLY LOQO..L NUMBER
1A. f.IRST NAJ\1E 118. MIDDLE
,
I
1C CURREt>lT LAST l-tAMEAT BIRTH(IF DIFFEP,ENTTHAN tel
9.. ZJPCODE 8 STATE/tOUIl<'TRY
: 108. ST)1:T"E0F BIRTH (IF o.UTSIDE U.S. COUNTRY)
I
7. errY 6, ADDBESS
1M. FU.LL BIRTH NAME ClFfATHERlP,1I.,REHT
2. DATE Of Blf:tfM (MII'\fDD/CCYY) 3.,SIATEJCOUNTRY O,f BIRTH 4".;#PRE.V.I"tARRI.A.GESfSRGP SA. LAST MARRJAGbrSRDP EI>lOED BY: [58.DATE'ENDED (MMfOD/CCY'f)
IJ D5AiH 001$80 P tJ 1ERM'RD'P 0
OF PERSON LISTED INFIELDS 12A-12D
fOREG01I'JG.1IJFORII'l.tl.T10J.J lSTRUEAND CORRECT
Ah.'f<::IEO TO E,A.CIi OTHER., THAT A CN.JF-oRNl...... MPRRIAGE LICENSE WAS
rJO\'VLEDGE RECEIPT OF THE Ir'JFORI,1AT10N REQUIRED BY fAt't'lILY CODE
120 Lb,qT B'lRTH (IF
: 128, MIDDLE
I
I
''PERSONP..LLY APPEARED BEFORE t"jE PNO 8RO\lEO TO l\>lE ON THE BASIS OF
ALL THE OF lHE LP-;Y\', ,llHD HAVE P.t:.10THE FEES PRESCRIBED BY'
CEF..'TIFICATE OF DECLARATiON OF r,,\ARRlAGE
22A. FUll. BIRTH i)F Iv\OTHERJPARHJT
17-.ADDRESS
12C .cURREi'JT lAST
13, DATE OF BJRTH [MM/DD/CCYY) 14.
WE, THE UI'JDERS1Gl>lED, DEC1JlJ;',E UIlIDER PEN!>,LTY OF PER,;JRY UNDER THE L",WS OF l '
TO THE BEST OF'OUR ,tl-JIO BELIEF. \"IE. FURTHER DECLARE THAT V,'C
O.BTAINED PRiOR' TO THE CEREM0NY, l'ND THAT THE CEREMOI-lY OCCURRED IN CA1.J%?
.:'.:'8.AND HEREBY PPPLYpt'R ALlCENSE ..a.ND CEFmFICATE OF -
n. SIGNAT.URE GF PERSON LISTED IlJ FIELDS iA-1D
J. THE UNDERSIGNED, 00' HERESY CERT1FY TH,b,T THE ABOVE
S;ll,TISFN::TORY E\!IDENCE,TO BE THE HAVE D
LP,VI! THESE REQUIREMENTS H,1.I.V1NG BEEN MET, I HEREBY 1S8U
1
T
11A. FULL BIRTJ{ -OF 1V'IOTHERIPAREt-JT
25A IN'\JEDATE (MMJODfCC'l"\'l : 258. AFTEB(Ml>!lJtCC'i.. 9F CDUNTY CLf:RK : 250" SIG-t>l.4-.TURE: OF CLERK OR D.EPUTY CLERK
\ 1.;-';:..... \ ISy)l--
: 26C COUNTY OF lv1AARIAGE
I
I
OF UtmER THE LA\VS OF THE'STATE OF CALIFORNIA THAT 'NE: VVERE .J2rINED IN IN
,3 li-lDICATEO SEl..OW
WE. THE ABOVE..,"J,.l,MED PP-RTIES, UNO
ACCORD,ll.l-lCE: \\lITH ';'F'1HE C
16A. DATE-oF

:17 OF PCRS.iJN LISTED ll-l 2B. SIGhlATURE OF PsRSON LlSTE[) IN FJELDS 12);,12D

. .
25E. U;::::EN&'ENUMBER 11:5F., COUNTY QE"!SSUE 15G RETURtj COMFtTEDJoA..RRV>.G.E.LIS8\'SETQ (INCLUDE ADDRE'$3j:
: ' . if'
I
WE, THE UNDER PEt1ALTY OF PER,iURY UNDER THE LA.WS OF THE ST,oJE OF C4LIFORNlA. THAi \.\12: 'v-\P.E PHYSIC.!:\lLY PRESENT AT THE MpRRIAGE
CEREMOIIJ"{ OF T PARTIES', THAT\'VE THE MARRIAGE CEREMe'I":Y, THAT THE IN
CALIFOEN!l\..I'J(O IS TRUE AND CORRECT TO TI-iE 8EST Of QU.R KNDWLEDGE AND
2S,6,..SIGl>lATURl OF V,'lTt4ESS ,/,' 129.0 N.A,II'1E o'F PERSON \,\'ITt-JESSING MARRIAGE (TYPE OR PRiNT CLE..!!;RLY)
\;; :
STATEJCOUNTRY, ANDZtP CODE
t30B.N.P.l"',E OP.pERSON IvVo.RR,IAGE (T'fPEOR PRINT CLEAP..LY)
,
.
Z.'0C. .ADDRE'SS. crry. STATE!COlJNTR.Y, AND ZIP CODE;
NEWMIDDLEAt:JO LA'ST t-JAME OF PERSON LISTED IN 1A-1D IIF AtN) FOR:US'E UPON SOLEMNIZATION OF11-lE MARRIAGE {SEE REVERSE FORJNFORMATIONj
31A. M\JST BE SIU.,EAS.1A 1318. MIDDLE r'31C, LAST
. I I .
NEWMJDDLI';:: AND LAST NAME OF PERSON IN 12A-12D (IF ANY) FOR USE UPON OF THE tMRRl'AGE (SEE REVERse FOR INFORMATION)
32A. FIRST-MUST BE sAwtE.A.S 12A, I $2B, MIDDLE 1.32C. LA.ST
I I
LOC';,A,l
REG'ISJRAR
33A,. NAl\>1E QF -Loc.4L REG'IST RM I SIGNP-.TIJRE OF CLERK OR DEPlH"'- CLER!{
I .
I BY.
1.$3.C. bATE: ACCEPTED FQR IS1RATION
,
I
STATE Of DEPAqTMENT OF PUB.L1C HE.1l.LTH, OFFiCE Of vrrPJ.. RE.CORDS. VS-116 'i.011.Li1l20091
90
STATE FILE
LICENSE AND CERTIFICATE OF MARRIAGE
MUST BE LEG.1BLE, -ll'l;!4{E NO ERASURES. y.,titTE-OUTS. OR OTHER .Ai..
. . USE DARK. !NK ONLY LOCPJ... REG lSi RAT ION NUttlGER
1A FIRST NPME 11E!.MIDDLE
,
1
1'C- CURRENT LAST NAMEAT 81RTH (IF OlFFEREklTTHAH 1C)
9.ZWCoOE 8 5TAJ.E1COLJNTRY
1.108. STftTEOf BIRTH (IF O.UTS1DE U.5_ENTERcour.:rrR)')
,
,
7. CITY
10A.. FULL BIRTH I>lAME OF-FATHERIPP,REHT
6.PDDRESS
2. DATE OF BIRTH lMt\VDD/CC'i'Y) 3, .. SJA'fElC:OUt\iJRY Ot"" BIRTH 4 .. #PRE\(. tMRRlAGEf;j/SRDP 5A LAST MARRJAGEUSRGP ENDED 8'1'; :58. DATEHlDED (lI'IMiUD/CC'l'Y")
a DEJ\TH DDISSG OANt>JlJlIvlEN10 1ERMSRDPD (
I ..SIGNATURE OF ':LERK OR C'EPUTY CLERK
, .

: 118. OF BIRTH {IF OUTSIDEU SENTER COUr,lTRYj
:
SJ:,?!E OF TH.>\T YVE A/?--E UNMARRIED AND THAT THE FOREGOING
DEaAF:E THP.J I'm LEG.c..L 08,:E:CTIOt4 TO THE MARR[.'.I,GE NOR TO THE
8y Ff>M1LY CODE SECTIOt,j 358 AN.QHEI-".:E13V APPLY ,cOR.f>.,
L-lf-:E OF PERSON USTEb INfiELDS 111',140
'l20.l,.AST NAIViE AT BIRTH (IF
1128. MIDDLE
,
I
RETURl'i COMPLETEDtv1ARRIll,.GE LICENSE TO (1!'lCLUDE f'DORESSl
"",. \:.
HAVE'F'ERSOI4ALl'{APPEAPD 8EFORE.ME. OR THE PERSON PERFo.RMINt3 THE Ht>.S
BE t,v,RRiED THAT ONE OR80T\-! OFTr{E PP.RllES .t..RE PHYSICAlLY UNABLE TO
N THE PP,RllES PROVED TO IIIE "THE BAStS OF SATlSFACTORY EVICEr'!CE TO BE THE
;;IF, THE 'VV, AI'lD HAVE PAID THE FEES PRESCRIBED 8Y .ll,UTHORIi:.lJ,TION HEREBY
THE STATE OF CALIfORrU., TO SOLE:MtJlzE THE M,:..RRI.:.GE Of ll-iE PERsmJS.
SF A.REDN Fl "E
CYY) f OF COIJNT'l' CLERK
,
,
2,5Jl.. 1SSUE Op.TE {MMiOD/CCYYj 1258 E'-'PIRESAFTER {Iv\MI
,
,
15E'.lYiARRIAGEUCENSENUIYl8ER 125'F
,
,
,
,
22,\. FULL BIRTH NAME OF MOTHERlPAREI,H
23.. SiGNArUREOF PERSON LiSTED H'l FIELDS lA-1D
ADDRESS
1-3 O/,,;1'E OF B1R.TH (MMIDD/CCYY) 14. STATF-.J::OuhITR{ OF 61:::<TrI
1. THE 00 HEREBY ('.ERllFY THATTHE A80VE-NA!<:ED PAR
PERSOI'lAIl YAPPEAREO BEFORE ME-AND PRESErriED;..N .".FFlOAviT
APPEl..R Aim EXPLA1NII4G THE THEREFOR IN
PERSmJS CLAIMED, HAVE DECLARED THAT THEY MEET ..e..J..L OF THE
G'lVEN TO ,toNY l)ULY .:.UTHL'"\F\'IIED TO A M!l..R
CDN$EI'lTSAi';O ;".FF'[I.ll,VITS -ORnlE 0;: - :5 L
WE, THE UNDE.RS1GNE.D DECLARE UNDER PENALTY OF PER,URY tl!'JDER THE lA\"{;3: 0
IS TRU6.ANO TO THE BEST OF OUR l<r-.lo...VLEDGE 8El
OF .f<. LICeNSE IS KNOWN TO us': WE.fl..Ci<N()'I'\'lEDGE RECEIPT Of THE IN
AND CERTIFICATE OF !-.-iP,RRiAGE
12C.. CURRHJT LAST
;tiA. F,l!Ll8IRTH NAME OF FATHERfP.4P.Et-rr
11A. FULL BlRT:-l NAklE OF IViOTHERIPAAENT
I 298- RELIGIOUS DEt.JOMINATION (iF CLERGY)
I
,
l 280_ OfF IC\AL TffLE
.'
I
IhlTRY. p.J\lD liPOJDE
.. Y,'ERE BY m IM,RRIPGE IN
AGE (MMJOD/CCYY) 1288. ClTYiTCiy.,1-1 OF I 28C-.. OF hlPRRIAGE
, ,
I ,
2'9E.-ADORSSS, C.lTY. 8T fiNO ZIPCOOE
28C., {TYPE DR PRINTCLeARlY)
lJJ ]6A. SlGtiD,TU.RE OF 'rViTNESS ; 268, t-l.oJ'!1E OF'PERSON Vv'ITNESSlt-IG MARRL"\GE (TYPE OR f?f-/.I!>lT.CLEJ:.RCYl
ge; !-,-,-==,..,--====,..,--fd"S, ----------------------------

'(J) 0::( _
'""J.P" 1 278 . Nf-MEDF PERSON WITNESSING t/tA;RRl.AGE (TYPE OR PRL"'lT CLE;ARL
;
"ii:\'f======
WI
2>-
2.
NEW'MIDDLE AND LAST NAME OF PERSON LIsTED IN1A,.1D (IF ANY) FOR USE UPON OF THE MARRIAGE (SEE REVERSEFORINFORMATION)
3OA. FIRST - MUST BE sAMEAS 1A I 30B. MIDDLE I 30e. LA,ST
, ,
NEW MIDDLE AND LAST NAME OF PERSON L\STED IN 12A-12-D {IF.ANY} FOR USE UPON SOLEMNIZATION OF THE MARRIAGE (SEE-REVERSE FOR INFORMA.TION)
31 A.. RRST - MUSJ BE SAME AS12A. I '318. MIDDLE ; 31C, LAST
, I
lOC..:J..
REG!S'TRt<..R
324,. ... OF lOCN.. R'EGISTRP.R 1328. SIGNATURE OF OR DE.pUTYCLERI{
: BY,"
I 32C. DATE ACCEpTED FQR
I
,
STATE OF CAUfORt-.lL,!l" DEPARTMENT OF 'PUBLiC HEPUH. CF.f.tQE OF VrrA!... REcoRDS V&117 (01IOV2009)
91
o NON-CLERGY o DECLARED o CONFIDENTIAL o PUBLIC
SfiUEF1LE:
NO ERASURES, WHITEOUTS, PHOTOCOPIES,
OR, ALTERA1JONS
TYPE OR PRINT CLEARLY IN BLACK INK ONLY- THIS AMEI..JDMENT BECOMES APART OF THE OFFICIAL RECORD
PART I INFORMATION TO LOCATE RECORD-TYPE OR PRINT IN BLACK INK ONLY
'IA. FIRST N.!'ME AS LISTED Ot,,) MARRIAGE CERT1F1CP,Tf JI.l FIELD 1,0.. \18. 1."I1DDLE NAlvlE 1'$ LISTED ON rAt>..RRlAGE CERTIFICP:Te IN fIELD 12,
i
le. CURRENT lJl.81NAME!'S LJSiED MARRIAGE CERTlflCP,TE FIELD 1C 10 BIRTH LAST NAME, iF DIFFERENT fR.Ot,}, FIELD 1C

.
ADPE,"'.RS
ON ORIGINAL
F,ECORO 1-'-A--F--,R--S=T--N--"'--"-=E--pS----US=T=E-=O-=O--N--M--AA:::'R--JA-G:::-c:--C=E-=RT='-=FI-=C--A,T=E--II--'I
4C. u1,81 I.JAME F:3 LISTED OI'!'MP-HR1P-GECERTIF'lCATE FIt:LD '11C : 4D. 611HH LAST NAME. if DIFFERENT FR('I"\ FIELD 12C
PART II STATEMENT OF CORRECTIONS TO MARRIAGE RECORD
5. ffi::M
l-JUt..1BEF: TO BE
CC,RRECTED
is INCORRECT THA'rAPPEARS '01-..) ORIG11jAL RECOR[;:J 1 CQRRECTED H->lFORMATIOl'J
LIST ONE
llEMPER
L11'JE

AND

We,. the certifY under penalty
information giv and correct. -
9A. SIG_NAIUl;'E OF 's'6',j ],
I> Ai, \ "+""
of perjury that'we have personal knowledge of the above facts and that the
: 98. TiTLEiRELATlONSH,lP 10 PERSON(S) !I>l p,t".RT I
1"OD. ADDI=<ESS{STREET ,AND I-lUMBER, CiTY, .STATE, .LlF CODE)
TWO
PERSON$
MUST SiGN
THIS FORM 10A. SiGNAltl.R,E OF SECOHIO P,ERSON : 106 T"ITLEtRELP.Tl0NSHIP TO PERSQl'l,(Sj:N PART I ;1 DC. DATE SjGNED;--MMJOD/CC,yy
TOCORRECT I>
AMAAR:I',GE
RECORD
STAl8L9CAL 11. OFFiCE OF STATE OR LOCAL REGISTRAR
I>
12, DATE ACCEPTED REGISTRATION
STATEOP CAUFORNlA, DEf'AKTMEIH OF PUBLIC HEPJ..tl-t OrrICE of V\T.Al RECORDS \.Is 24-C181fOV.<.-oQ9)
93
COURT ORDER DELAYED CERTIFICATE OF MARRIAGE
STATE OF CALIFORNIA
OR AlTERATiONS
S1.t;TE FILE NUM8ER LOCAL R5GISTP.AnoN
TYPE OR PRINT CLEARLY IN BLACK INK ONLY - THIS FORM BECOMES THE OFFICIAL MARRIAGE RECORD
lIB. MIDDLE
I
1G. CURRENT LAST NAME AT81RTH (IF DiFFERS,,) THPJ':l iC)
1000,. l"iA.ILJNG P.JJDRESS (IFOIFFERENTj l,ws.crrs j,,, t: 110D LJPCODE
l-:1"CV-,.-='"CU.L"CL-:S='R=TCCH"CN"CAj'C:'1E=-,""F=-FCCA-='CCHE=R-:/pCCAri7n=EI<-:.,:-----l...f } .
..o,:X?,';,.
2. CATEOF BIRTH I" STA1BC0iJNTRYOF BO'<TH /" # PREY IAA'<RI"GESJSRC\O
6. pnoRESS 7. CITY
SA. LAST Mp.:RR-l,u.GEJSRDP Et.JDED BY;. !SB. i)f\1E ENCED
o DEATH 0 [1IC,50 0 .0 TCRIl'\ SRDI:' 0 1M
I
12.'\. fULL SJRTH NAI.,.1E OF MOl HER..'PAi;'ENT
r' COUN1Y OF MARRIAGE
I
\
'011Y !22C STATE iL2D.ZIPCODE
y' I I
I"'" CITYfTOv>'N OF MARRIAGE
F,lILl 81RTH NA-l.,.\E OF F/>.THER/PPRENT
22A, tMIUNG. ADDRESS (IF DIFFERENT)
1e..,ADDRE$3
"'C. CURREIH LAST (t, i
10
9''fASl NAME AT BIRTH (IFD'FFERENTTHAN Ie)
FACTS 'OF
MARRIAGE
NEW MIDDLE AND_LAST OF US:cED IN i" -10 Ah/"{' FD" OSE l.lpml SOLEMNly.,TlDN CF TrlE M.z.:P.PI ....SC (If DIFfERENT l'"rl,tJ.; iB A!"W 1C)
2$..0... FIRST MUST 8.6 S.AMEf{2.1A FeB. MIDDLE j28C. L,:AST
NEW MIDDLE AND L:..3T NhMEOF USTED iN 1'3-t-. -13) (IFANY),FORU$E .uPON sblJ::MNIZA'nw OF. :rHE MARRIAGE (IF DIFFERENT 1-38 AND laC)
:l9fl-, fIRST- MUST BE: SAJI"iE AS 13A j29B. MIDDLE
i
129C.lAST
i
STATE
REGISTRAR
USE DNLY'
OFFERED FOR FILING PURSUANT TO ORPER NUI.BER _
OF THE SUPERIOR COURT oFTHE STATE OF CALIFORNIA, /14 AND FOR THE COUNTY OF _
MADETHE PAY OF ,A,D, 20 , ESTABLISHING OFRECORP THE FACT OF MARRIAGE IN
THE STATE OR COUNTRY OF . NO MARRIP.GE CERTIFI,GAT\OHAS BEEN FOUND ON FILE IN THEOFFIG,EOF VITAL
RECORDS FOR THE ABClVE PARTIES.
3d, ()FFICE OF RECORDS r" C",rEA-:CEPTED FOF; RE,ISTRATION
STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH, OFFICE OF VITAL RECoRDS FORM VS 122 (Rev. 1109)
94
1
1
... 1

'-4
ANOC;ERTIPICArg OF N,AJ,;RIAGS
FOR DENOMINATIONS NOT HAVINGCLERGY
l.
I
I
,
I
I .
95
! .
I
1
ST-A1E FJLE NiJlyiSER
LICENSE AND CERTIFICATE OF
DEcLARATION OF IVIARRIAGE
'l,,1IJST BE LEGJ8LE NO. ERASURES, VI'HITEOUTS. o.R OTHEF>; ALTERATiONS
USE DARK INK ONLY
tANAME - fIR"S:T to.MIDDi..E
1C,GURp.f:NrLAs'r
2.,DATE (IF E<lR'l1-:l (t.,I.VOo,'CCYy) 3:S--r....1EtCOUNTRYOF BIRTH
B.f..DDRESS
NAME OF Fp,TrlEF:lPNSEN1
7 CI1Y
lAST MAAR1AGElSRDF' ENDED BY: 53 D'<.TE ENDED
I (MhI,lDDICCY',')
o DEATH 0 DfSSO 0 0 TERM SRDF DN1A, I
CITl'JTtf;!',"NOF IMRRI.'-.GE
,
2EC. COUNTY.of MA.P.filfo,GE
I
I
I
I BY r
OF CO\lt{W CLEP.h
COMPLETEDl,1;.RRIN;::' TO (INceJDE
\
2.J:uLLB1RTi->
tV... Fl'I...L 8iR1).; NAJrlf..
1:::'''='' NA!>1E- FIPSJ"
'"
,3. DATE QrBIRTH tMM.1JD/Q... :Y'l') 14.si..;T'E/COll!'l1F.YOFBIF-'lH

'"
1i: 1'1 ':',[rDRESS
02
Z'!J
80
21,0... fULL B:RTK l\l,AME Of FAiHERIPARENT

2'.'- I"6 "iWE'OF PERSp" ,,,",.ESS'N'i M'fIRIAGE l'YPCOR pRINT CW"",")
STATEICOUNTRY,AND ZIP CQ[tE
I .'30S. N.:..ME OF PERSON M;4'.RIA$E{WPE OR PRINT ClEA?lYl
30C,AOQRESS.:CiTY, ZIP (}'ODE
LOCAl
FEG':lS1,r::f.,R
I 31B S1GNAT.URE0Fq..ER1-;,O'RDEPlT,fYCI,RI{
16y
1 FOR REGI$TRA.TION
I
Y&-11{1U':Zl(5)
96
UCENSE AND CERTIFICATE OF MARRIAGE
STATE FILE I\iUMBER
MUST 13E lEGlBlE - MAI<E NO Eh'A.SURES. 'tkiITEOUTS. OR OTI:lSR ALTERAnON$
USE DARK lNK ONLY LOCf-'.L REG.ISTRATION NUMBER
If... I 15.MIDDL{:
:
I
"\e,STJ-.1!;!COlJN I-RY 19 tJP WDE
Ire. BThIE OF BIRTH (IF OUTSIDE l1 B.ENTER OOIJ!:JrRYj
I
1118
:
t 1D.lAS'r I>lAME "'.T BIRTH (IF DiFfERENT TliAN iC)
! i';''6" MI[)OLE
I .
J
I
'1 'CITY
.:I,; PREV..M,tRRIAGES/SRDP \ SA. L;.,STM,.J<!RIAGElSRDF'H10EDE.'.-;
_ _ I tMMIDDlC:CYy)
o DEATH 0 DISSO 0 p.,NNUlJ.\Sn 0 TERM SAD? 0 W,t.. I
22':". FUI...LSIRTI1' NAlrlE
1""'-, .9:=251
12..-::.. l"-ST
6.AOpRESS
, OATE OFBIRTH (.'''OD/CCI'Y] I' S<AlSCOONTRY CF BIRTH
we,THE v"DE"nll .... THE S1"AIE c;R CAllFCf:.!>lIA HI1,HE fORe<>CJlNG-lt,n'if."::"lT1i:'N Isnb, "-ND C{>;lRECT To-THEB!'.::;r OrOUIl WO'&l':lIEf ,WE FUiI1HEF< tJECL.<f:E 11-' ....1010
LEqAJ. "5JEttllr;Ol ro:/1Hf .. "":.f;'i)lHE 'SSlJ,o.)":E OF "'UCE"'Sl:' LIS. WI; ACl''''O''l!:F.DGE iiEmr, CoO C':'I:'I;. ::5f,,,,,Jrl ......0 Cf>lllr1C."'Tf.c,f "''''RRl,..::>E
23. USTE!?lN .AEL.DS 1A-',O :". PERSON FIElD:;> 12."':-120

25-; lS5UEbATE(ll'Il\i,oDlCC.'A''i 11 . ..,2SC N).J",EOf : z,-n -S1G-1N,TURE OF ClERKOR DEPIJ1YCLERK
! BY'
25E U"CENSi: NUMBER I TO iINQ.UDE
J
27B.nll,.'tlE OF PE!;!SCNWITNESSING PRlrn CLEARlY)-.
I
(if TI'lE m'l-TE \.i' >:iiJfCffl<lJ,<,. THAi TH! Y-ll"ED,eYI.\E t" I....TI1 THE lJ:ll'lS':'Y iH!' Pf c.ouf0RN1;t,
":OTE, THE "'.oRRI",!:,!,
2at., DATE 010 MA.RRJAGE
2s:-"SI.GHATURE Of PERSON
2EC. NAl>\E OF PEJ:$ON :>DlEI-INIZING M"-RRIAGE (T\'PE OR PRIN-T CLEARLY)'
':"OORESS,crn-, ZIP CODE
! :"80 COUNTi',OFr.\ARR1AGE
I
I
:l9B.REUGIOUS DENOMINATlUN CLERGq
290.0FFltlAl.. TITI
I
I
lOc;'l
REGSTRhR
\ OFCL..!:RKCRDEPI,.'TYCLERk
i BY ,
: roo. DAI E ACCEPTED Pffi REGISTRATION
\
STATE OF DEPAATloiENTOF PUBLICtiEPl..Ttl, OFFICE a= V1TIJ..RECrnOS
97
SlATE FILENU1Y18ER
CONFIDENTIAL
LICENSE AND CERTIFICATE OFf\IlARRlAGE
MUST BE. LEGlBLE;... MAlKE ERASURES, 'tIrlITEOUTS, OROTHE'RALTERATIONS
USE OARK INK ONLY LOCAL RE.(?'ISTRATION NUMBER
1A. -,FIRST 16.JvlI[llJI-!'.'-
lC.. CURRchiTlAST
'"
I;.;: 2..o;::TE OFS1RrH (MMIDDfCCYY) 3,STA"TEfGOIJIHR\'OF BIRTH

00
"ffi

u:. to'-l,FUUBIRTH NAME OFfATHERJPARE'NT
7 G1TY
(1FDIFfEREt{T THAN 1C)
lAST MARRL4GEJSF.:DP ENDED BY' DATE'ENCEO
I. Q-.lI;\r:JOJCCYY)
o DEf...TH 0 DiSSO 0 0 "TERM SRDP 0 'NIA I
25D.SIGI'lA'JURE OF ClERKOR DEPUTY CLERK
I
I En
I :t,1!: GOlJN11' cF
I
I
I
I
I 1'13 ST;t.,TE tF B1F/l'Hilf OUTSIDE
I '_'" '<"t:::,
\,.. I 22 OF BIRTH (IF OUTSIDE U SENTER COUlffR\1
'\;I ,
,
l ::SS. REUGIOI.lS-DEl'jOl\-11NAT10N Or GLE'RGY)
I
1150 OFfIClALTITLE
I
-"';'!;;;., 2.::. SIGNATtfRE (IFPERSON USTED 11\1, FIELDS 12t.,..12D
-,
1Et.j::ITY
I COMPLEl"EO.M"ARRlp.GE:\JCENSE. TO (INQ1jDEADDRESSr
I
216 CITy OF t-ii,l.RRlAGE
20E.AODRESS. an', 5TATEICCDNTRY.AND ZIP CODE
OF P.ERSW USTED IN FIELDs 1;...10

Cf C<.UfOfdll .... 10 SOLfH.-liIt' HE ........'RI'OC'E (,r 1HE TO-f,ol.lllY ,tiE o,I-iol1Rl.. t.f
BEW'v.
>-
"
b
>-
w
r.rr
ili
u
::J
'lv... Fl;ill. BIRTH i.Z..ME C'lFMOTHERJPARENT
n..; 'FULL BIRTH I'JI..ME Of 1.10THEP'lP,.<:.p.EN'r
lX. CIJRRENT L;;Sr
paJ/'lTY

2g..l.,. !>l .....ME OF CCUNT,< CLERK :.298. SIGNATUP..E:cr CLERl-( OR DE?lJrY CLERK
I
I BY ,
I 29.::. DATE'
r
SlATE OF CAU-FORNIA, DEP.4RTtt.ENTOF.PUBUt1;iEAL'n-l. OFFiCE: D;=YlT;J_RECCROS VS,i'i'3 (11/2(\08)
98
AFFIDAVIT TO AMEND A RECORD
ORALTERA110NS
BTATE FILE-I':!Ut... 18ER
D PUBLIC oCONFIDENTIAL oDECLARED
LOCAL, REGISTR,A,T1Cihi
D NON-CLERGY
TYPE OR PRINT CLE:ARLY IN BLACK INK ONLY - THIS AMENDMENT BECOMES A PART OF THE: OFFICIAL RECORD
1,1',. F!F;;'ST NAJAE AS LISTED 0N i IFlCAJE iNFIELD 1A
CURRHJT LISTED 01\1 h!iAP.$l""'GE C;::ERTiFlC?,TE' IN FIELD 1C
; 18 l>lilODLE tlAlv1E AS USTED Ot>!. Iv'AF:Rll.GE CERTIFICATE IN FIELD 18
l'D.SIRnl I-I,AMEAS USTED ON 1l''lft:F;lAGE IN fiELD 1P
---------------i-:\,.'?-.r:-;o:-u-::-":::n-::-'
APPEARS
OI'JOR1Gil'1;L
RECORD f-::---c:c=---:================,-----S===================-----
4A Npj.;1E -FIRST AS eN CERT,IFlc".;rE FJELD 1:21\ \ N/;h1EAS USTED ON MA.RRIAGE CERTlflCAT.c. IN FIELD ",2B
4C CURRENT LAST AS lISTc,-D ('N MARRl4GE CER"(IF\C.b,TE IN. r-IElO 12C [4D BIRTH 1.1',5T i'lAME.Af3 LlSTEDQH MARRiAGE CERTI;::lC.A.TE lI-l PIELD t?D
5-
i'JUI.l!3ER TO BE
c.:ORRE(TED
L1STOI>JE
ITEM PER
LINE
REASNJ 8..
FOR
'O:PPEGnCN
6 Il'lCORf-':EC11J-lfORMAnONTHAT ,!l.PPEAF!S ON ORIGMAl RECf)RD 7 CORRECTED INr=ORM,o,T 101j _AS rr SHOULO APPEAR

lec DATESIGNED-foMiDDICCW
,.00. ADDRESS'iSTREEJ AND t"jUMBER, CliY, STATE,ZIP CODEi
9D. ADDRESS (STREET f.,NO t'JUI,1BER. CHY, SlATE, l!P c6DEl
We, the certify under penalty of perjury that we have persona,l kno\'tIfedge of the above facts and .that the
information given above is'trueand c-orrf;!et.
"SlGNATtPES OF FIRST PER-SL',N
nalO
PERSONS
MUSlSlGN !----,-=-:---::--::--=-::--::-----------r---:========= == ---r-= -:----:--- ---
TH1S FORII'! SIGi-.l.P.'rURE OF SECOND PERSON 11oe-< T1TLElRai.TloNSHIPTO PERSON P,Jl;RT I 11 OC,DAI E
TOGDRRECT
A.f>1foRRII..GE f------------------------'------------------'-------------
RECORD
STATEfLOCA.i 11 OFFiCE OF STATE ORl.DCAl, REGISTRAR
REGISTRAR
USE ONLY'
STATE OF c..-n.L.IFORN1A. OF PUBLlC.HEALTH, 0FFICE OF VITAL Rt:CORDS
99
1'2- DATE ACCEFTEo. FOR, R,EGISTRA,ION
S1t-.TE FILE tlUf>.-1EER
FOR DENOMINATIONS NOT HAVING CLERGY
1\r1UST BE LEGiBLE -tkAJ<E NO ERASURE;;:, \':".t1lTEOUTS, ORDTHER ALiERAT'IOl'l$
USEDARK It.JK ONLY LOGliJ. REG1S:TRATIPN NUh.18ER
1A,N;..ME-\X"P/>.RTYA- F:RSr ..M18D.LE
9 ZIP-CODE
ENTERCCUJNiH'i'}
I 250. to\"tt4TY"OF"MARRl",dE
I
... U--.ST"I,V..RRI;(G5'SRDP ENDED S':!; 58, DA1'E !:lm!;:D
I (l>1ti\(DD.lc:eYYl
o DEATH DDISSO 0 MNULMEIH 0 TEF.i..l5RDP 0 NlA 1
lQ.u.,s1tj,!.,MEAT6IR:rH (lFDIFFEREtn :H.....N te)
28. SIGNATUREDF PN'!n'B
i8 GllY
7. CiTy
'3. DAJE-Of 5IRTti (t,olMlDDICCl'YJ 14. -STATE/CO.UNTRY OF BIRTH
22:.. FU U. Bl.RTH liAME Of 1.10TI:iERRARE:NT
17.ADD!'l:ESS
10:- FUu..piRT)--jl{.t:..ME 'JF-fATHERlPARENT
lC.CURRENIL-\ST
6.ADQRESS:
>-
0:
o
t-
W
VJ,
Z
g
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Do
D
"
0
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z
0 0
2
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0:
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i c
.Q 0-
0.
0
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0
0
0 <0
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0:
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,-e, THE U\>IClER$'(-:r'lE-D ..I>ECL"RE '.,,lpERPHIPlTYGf it-E hIt: S',<.1f'(>f C)OFO!1">lIA, iHE " .... C"fif''''otiYOF THE ll-'l..:.TVvE ...... ;:tlE!;S<',O TliE .-eO\'!:.
THAT'THE CE:P.EMQNY q.:CllF<F<EO tll ..:ALIF'::;<OOlo..,,,o,.u ...T 'Slf;;t1f Nit; 11"\ OCST OF 00i'< y.N9""'UOC{: .-<tlDf:,Et:JEf.
'1 IJFPERS<')!'! MPiRRl);.G6 {TYPE OR PR.INT YJ.
I
30:4.. $IGttll.TJ.I,RE (IF"WiTNf.SS
30C .. CITY. '$.T,f-.TE,co-OtH:RY. J>.NO ZIP
LOD-4..

31;; OF l.OC,llL REGlSTRA"<. 316. SIGt-lATURE -OF CLE2!{ 'OR O::P.(ITYCLERI:<
I
I 8)-
(
I
STATE 'OF -CALlFO.=?Nt.... DEPAP.n,1ENT OF F'U6L1C HE....U!"l, OFF-ICE Sf VlT,i..LRECffiDS \!S.11515'2\)OBi
100
STATE FILE NUf..iBER
LICENSE AN.D CERTIFiCATE OF
lv1UST 61:: LEGIBLE .... M.A!<E NO ERASURES. ,t'MITEOUTS, 6R OTHER-ALTERATfoNS
USEDARK INK ONLY LOCAl REG:ISTRAT!ON NLJI11BER
26C. GOUNTYQFM!.,RRIAGi:
16 STA1EK;C'UNTR'f I9,.ZlP CODE
1ffi STATE OF (IF (lUl$IDE U.S. EIIIT.ER.COUtiiTRY)
I
1.118
I GAlE El>lDEO
I (W,M80;Ct:'l'Y)
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sat, ADDRESS.. CITY. STJ."T'EfCOUIHRY.,A'IIG ZIP CODE
I 2'.38. NAt.l!::: OfPfRSQNv;11NESSlNG [TYPE OR F'RINTt:LE:l\?L'.')
I
30B'. N,ll,.I/,E OF l-..I..l\RRlhGE (TYPE OR PRlt-..T ClaRLYj
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I BY ,
31C. FOP. REGISTRATION
I
I.
Sl,o..TE OF C,>:.UFORNIA. DEPAATMENT OF HE..tl.LIH, OFF1GE op .n.eJ.. REJ:CRDS VS-l16 (ObQ.J03)
101
LiCENSE AND CERTIFICATE OF l\lIARRLAGE

t'l1.lJST gE LEGI8LE NO ERASURES, OR OTHERAlTERATIONS
US.E DARK INK O,NLY ,lO('J:J.. N\JI'r'18ER
lB.MIl)DW:;:
'"-'50. T:lIRE OF OR DEPlITYC'!..EPK
'1
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I liB. STAlE L1 S. E1HER
1
5A.l:"ST I.IARRIAG83RDPE1'JDEDBY; 5\3. -DATE ENDED
I (Ml>V:JDICCYY)
o DE.4.TH D D\SSO 0 ANI'lUU.\Ein 0 1ERM SRPP 0 N/A I
T26J,.lIODLj:-
:"6?NAME OF PERSON. lAARRIAGE (TYPE lRPRIIH CLEARL;y)
I ns, Of {'TYP,E OR,PRINT CLEA\3LY)
.I
7. CITY
13. CITY
l:<C. C1.lRP.ENT LAST
FUll.. BIRTH Nl.J0E OF MOTHER;PAAEln
13. D."'.TE OF' BIRTH p,.\I....'ODlCC'fY) 1<\. STATElCQIJNTRY QFBIRT-H
:21,; FU1J..BIRT.H NAME.
2.,DA"TE OFE1R'TH tMI..llDOlCC'fY) e:STATEJCQ.UNlRYCF BIRTH
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WE MMR1,..GE f'l..,cE IN
-OF
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2E .ADDRcSS.CITY, TEICDU"!TRY,AND ZlP CODE
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1
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290, OFF11J1.:.L TITLE
!'lA.ME.oF LOON...- RE-GlSTRAH 13[l8,SIGN)l..1lJREOFGLERKORDEP-UTY-CURK
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roc., bf,TE ACCEPT.ED Fa:: REGtSJRJ.;;lON
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STATE OF C;t;IJFliRNI.b." OEPAATI.1ENT OF PlIBlI(: HE.4J.TH, IJFFJCE crYiTAlRECrnDS
102
STATEflLE NLirv'oBER
QONFrDENTIAL
MUST SE LEG'ISLE - M?J<E ERASLlRES. \"MITEOUTS, OR OTHER ALTERATIONS
, USE DARK'INK ONLY LOCAL REGISTRATiON NUMBER
2U. ZiP CODE
25D.S1G,NATllRE e'F ClRKOR DEPUTYCLERK
I
1 BY'
58, DATE ENDED
1 Q,WJDD/CCYY)
o DE.:t:.111 0 DiSSG 0 ANNUl-MEIH 0 TERM SRDP 0 l'JfA I
1Q tASTNAME-AT BIRTH OFDtFF.ERENT THAN Ie)
18 CIT';'
7.ClT'I'
21A,FULLBIR1H OfF..c,THERn"ARErll
17 ADDRESS
13. Qt-,TEOF 61RTH 14,T.:"TEICOLtIHRYOF
12C.CURRENT lAST
1UL..'FlllLBIRTH N,ll,ME OF FAiHERlPARE'Wf
6.;..DDRESS
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NOTE: C!:'F.HoIONl',"UST l;>h!:'f'V,CE Iff 1HE'C{IoUN1\' li""\'I,'ttCI:! JIiELItENSE WAS ISSU!:D f..S 'l'i:li1jF'l!:'DI" f.!;;)\\'.:.
2K: NAME OFPERSC!N (TYPE PR'PRIIHCLE.l..RL'y)
21A. Dt,TE. .Of (MM'DDfCCYY) 278. -GIn' Of-IIiARRIAGE 27C, COUNWCF I,\ARRl.':"G:E
1 2aB. REU(-IDU.S O.EN01-iINATlor1 (If CLERGY)
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1 280.DFFICt,A.LT-lTI...E
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I
::;.TATE OF C;J..IFORNI';' DEPFR,tliENT Qf pU8L!CtlEAlTH,DFrICE'tFY,l;:;L,RECCRIJS VS-l23 (!6.iXloa)l
103
STATE. FILE NUMI3ER
1A, N;t.ME Cf P,.':.,RT'r' A-.FlRSl
LICENSE AND CERTIFiCATE OF MARRlAGE
FOR DENOMINAnONS NOT HAVING CLERGY
,\-lUST BELEGIBLE ERASURES, OR OTHER -ALTtHATION.8
USE DARK lhlK ONLY
I HLMJDDLE
I
11Gl.U..sT NAME .z"TBJR:rH (IF Ttf,l1.l>I Ie)
REGISTRATiON NlJl\1SE8
.::L #. PREVo MARRI,<,GESI SRDP 15A U;S'r t;\'::">':RIAGEilS.RDP ENDED I CAl EEIWEO
. I (M1,v:)O/CCY"Y)
o DEATH 0 DISSO 0 ANNUU;jt:Wl 0 TERI.i SRDl' 0 NiA 1
6.ADORESS
FUl.L8IRTH
1X\. CURREI'iT L4S,r
13. DATE OF 1<. ST>.TEICC.Ut<",' Of ."TH
17,ADDRESS
22A FULL BIRTH OF l.101liEP./PARENT
23 OF P.J.RT'{/"
7, CITy
18 CIT':'
f:, ". """,-.. . J
\l;(\j'!r!
18 SlAT80C\.IJNTRY" 19LIP CDPE
! lC6 STATE' Of BI,RTrl (IF OU'fS1DE i.l.8. ENT,ER CQUtJTRYJ
I
I
J ,THE >-IEfiEI:W lK".l THf' PIf/l:tS"",,,V;: #'f"EIIi1"F.D TO t<"S1S QFkt,m:.<'ACTORYE VlOtN;:l";' 0 ftI: HiE lie Q!;l'Af.D.Ji...,'[ fJECL#lEJ) irlAfTKEY'M?'E"i Al.1.
f{E.;>uIREMEN'S Ttl? U'::fllSE .......O I;f fOr, 1<01 l'A\.\HC. i:LERC_\'
\- .. :e:-,,"<
(15G RH)JRlIj COMPLETED-MAAF;:lAGt TO (lNCW_DE" f.,DQRESSJ
1,'>'I;1E or COUNTY CLERK l25D. ,jF ClERK OR DEPU P( CLERK
1 BY;'-
\'>, THE ..fotED PAA1IES,DECURE tll'iDER of'THE 'SlATE .C'f-C;,U,-op'NI,o" nt/;, WEWERE J:)flOfl.'-I!,! 1-\,ARl';:",,,E IN ",CCORC,ANa: WilH fHl: RL1]S,.."1l CUSTClI-IS:Of OUR REUGIOUS S((:lE IYOR
r;EfJO"I'r....'IJ-"lh(.-.N!' It/;%Ci:I?Do'-liiCE v-.11K'lnf
: l?5D.'';Ql!r-i!y OF h'lAARlr\03E
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lKE
"2M : 2'38. NA.... E (IF wm'!::S$lNG !.\A,i;'.Rl""GE .(TYPE DR .pRIH,T Ci.EAAlY)
1
LOC.ai.
..t.R
I 31B. CLERJ{ OR C\.E'1I{
I 'BY'
31C D..t..1E ,c,CCEP'iEO-fGR
I
I
S,T.I\TE Of C.AlJFORI-JlJ." DEPARTMENT OF PUBLIC HEP-LTt'!"OFfICE. a= 'IlTi-1.RECtf;:OS.
104

SlATE FlLE
liCENSE AND CERTIFiCATE OF
i"lusr 86 lEGJBLE tW ERASURES. \\HITEbUTS, uR. OTHER ALtERATIONS
USEDARK INK Oi'llY LOCAl REG:iST8.ATi9N HUMBER
'lA. NAh1E -Cf P,A.RTYA--ARSr lEi.M10DLE
1C CURRcrJT LAST
2.0A11:: Of"-SIRTH (j,11,1IDOfCC'r.....') 3 ST..... B1P.1H
6 ADuRESS
1(1.; fULL8iRTH NAAlE OF F":,TIiERlP!'RclJT
i .. C1TY
5!l. LtS11I\ARI:::'j.-".GEiSRDP -ENDED S\': 5';3, DA:iE
I ... LVCC.y'0
D DE;.,TH 0 OtsSO D 0 TERM SRDP -D J;}A I
9,ZlPCQOE
!'ND CORREC1 .T01l-1E BESl Of OUR E-.:UEf.'.... " tlECL<1:E ...11"f.:
lIF.I-OEO\NC"-lfC,,tl!A ::.ofltlE
228. trAtE OF BIRn, ilF OUTSIDE-U.S ENTER COliNTR't)
18.CITY
23. SIGN.qURE OF P/RT'i' A
n.l." FULL BIRTH \iAME OF MOTIiERiPARE-NT
n,ADDRESS
nw, '"'''' M,'
_.. ,<-..",,,,,,,,".
lX:. CURRENT L;\'ST
13. n',;;:E OF E:IRTl-l (MI..IiDDIC(YY) 1.:l. STp.TEiCbUN1Rl' OF BIRJH
12.:.., NAI,:1E OF PARTY' 6--;'FIRSl
11':'.' FIJLl BIRTIi NAME Of I.'IdTHEP./PARENT

t-iERnW A"PLYfOR .o'l[ (If \.j"':f:t"'E ,-
:60, OF CLERK-OR (iEPUTY CLERK
I
I EN
26C-._CPIJNlY OF I<t-;RRIAGE
I
I
I N""".-1E OF PERSON MARRlAGE(TYPE OR PRINT OLEARL't)
I
28 OF P....RTYB
I j:':ET'JRN Tt'(It-1a..llDE ;".r)DRESSj-
I
I OF'PERSON lrlAARIAGE- (TYPE OR'PRINT ClE,l:..Rl"
,'I
I
SIATE.c(tUNTRY..A'IID ZIP coDE
2!lC. 1"nOREs-s._CIT( ST.4.TEICOUNTRY, AND lIP CODE
::IDA. SiGNATURE OF
25-'-.., ISSUE Q.;TE_(MM.GO;CC'fYj
l)lDER PER..lJflYUNDER T,"E L"HS.O" THE !:""_lE (of C,<oUfuRN1A.nl':.TI"I \,,P.EPHYSlcou..yPRESE;l-IT AT Tl'lfMARRI.<l3E CEREIolbl-!YOnKE
o;:n'e"'''J\'. 1,,"T Tl'f .'>/00 ,HAT lNR)R......llg.>' lS-Tf(UENilD l;O!':!'HoC, 'rOll'lf i:>n:J Of 0IJIl..I(NO''Il-F.O-'!O;>l-1l)
LOJ.4..
'F.fGl,STRAR
S-ip... hlAME Of LOCAl REC4STRA.R 3'8. SlGl'lAHIF:E OF CLERK DEPltl'YCLEPY.
I
t BY ,
31C. D.A:Tf,ACCEPT.ED FOR REG1STRAT10l_
I
I
ST,<.:TEOf C... [lEPAATtAENT OPPlJ6LlC HE.....Ln-l. OFflCE'CF\iJTN-. Ri:-CtRDS VS-H6!O&:2nOB)
105
LICENSE AND CERT(FICATE OF iVlARB:IAGE
STATE PILE NLJIv1BER
MUS, BE .... MAJ<E I'JO' ERASURES. V'MITEbUTS, OROTHSR AL
I,iSE'DARK INK L0-9AI- REGISfR,o;nON NUMBER
1,.., NAt,if CE PARTY A-PoBST
l.C. CLJp.RENT.L;:"s1
2..D':<l"E OF B1RJH (I/.MItiDICC'A') 3 STATE/COUNTRY a= BIRTH
6.ADDP.ESS
lQt." Fuu..8IRTr! OFfft.THERIPARENT
5A. L.c..STM,:.AA1AGE/SRDF'ENDEO EP/', 5(3:. D,A-TE 'aWED
( tMI>iIDDJCCY'f)
D !:;lEA-.TH 0 u:sso D 0 l'ERM SRDP 0 NiA I
9.2JP OJDE
OF BIRTH (IF OUTSJOE U.s.EJ'OlER CmJrJTRV)
111l:l
il'.,>HD CQ;'IRl'Cr TO THE BioST OF OUR ,>HD.llELlEF, we rUFlTHERDECL..-RE: W....T 1>0
f'YF...... U..Vcor", HfP-rBY Al'f'L\'fcip., AL!CENSE ..NO o';!:'RrIFIc....ll, (.f IolARRI.oOl:,
p"'13T'rs
QF?ERSPN V.'TNC--SS\NG DR pp.rNT-CLE....RLYl.
H!.CITY
I TO (lNQLJDEi'-.DDRi:'SS):
1
2&\. StGNA'fURE OFWrTNE8S'
MARRIAGE NUMBER
FULLBIRTH NAME'OF1i10ThEP-iPAAENT
17. ADDRESS

.. CC'{'() ::'56. EXPIRES '::'FTF.R{l-.iMIi:>:CYY) \:C'. 25C:. H.:',ME OF-COUr.. :tYCLERK ?:'-U, OF GI..ERKOR DEPlITY ClEP-K
t 'It, ,:
13.0"TE or: BIRrI'! 'Q.4IN'CI13/CC'{)') 14. STATE/GOUt. TRY,OF BIRTH
11,:., FIJLl.S1RTH 1'!.AME Ol"k1OTHERlP.:':RENT
:=:;
?3,SlGNATUREDFPr",..RJYA \1>.

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NOTE: THE "'#>.'Rl".r.>f. l.-KE PLI>CE II' HE :;1",T:'0,
2.SE..ADDRESS,;ClTY. S'r.c..TEICOUN1RY,AND ZIp COD.c.
5bj 2&... DAT.E OF MARRIAGE {f;IlMIDC/CCYVl
(0 (')

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'68 (;lnrrOWN Of M....P.R1AGE
I :;!9D. 'rFll.E
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WC..<;,L' S(j.;. NA\wlE"ClF WCAL I 308. 51GNATlJRE OF-CG::'"""RKQRDEPtJ'rYCLERK
FEGlSTRAA l. I
I E:Y f
I roC.oATE ACCEPTEDFC-R REGI.S1RATrON
I
I
STAT.E OF:c,;uFCIRNIA, OF PUBUG HE,t;Lil:\. OFFICE CFYiTAlReCo;:mS- YS-\17 (06.l2llClS)
106
$1ATEFILE
CONFIDENTIAL
MUST BE lEGJBLE -MN:E NO ERASUf;:ES. \/;il-jITEOUT:::. OR 011-1ERAi..TERATIONS
USE DARK INK milY LOCAL REBISJR,cqi9N HUMBER
NAME 0= P.!"RTY A-FiRST lB.IJiIDC'LE
:;?, D..;iE CiFSIRTH (1<1It'lrDDICCYY) 3.,ST,;lEfCQlJN'r.::':YOF BIRTH
6.ADORESS
10l'.. FULL BrRTI:! N.AM-E OFFATHERIPARBH
i .. GlTY
BIRTH (IF 'fit..N lC)
5:-. -LAST M.o.P.RJ,t..GElSRDP 5(3 D.-"i1EEN:cEO
I (MMfDDJCCYY)
D.DEATH ODlssb 0 ANNutJ.IENTD ONiA (
S.21PCOOE
EtHER'COlJNTRY)
't'E ;.NOCORflfCT TO 'THE BEST Of cOllI': !lIKl':"l..EDOE NoID ""LIEf. WE fLlF;THH: OccURE 111;<.1 NO
,!<yFAlJll\' roDt; HERE<JYAl'f\.-YfI'R ,<.l.JCENSE .qiI:l CE!'ll,lFiCAT'cr
I l1B STATE
,23 MIDDLE'
IF. CITY
I 2:5:'. COUNT'!' Or j'l;Sl'E \i :,., F:ETURN CQMPLETED MARPI ....'3'!: UCI:'NSE TO (1t*a..lJ,DE
1 ..+1i'J !

(MM.00,CC'f'{)
13. D.t.,1E OF BIRTH {MINDDlCCW) St.::.,TElCOUNTRY OF BIRTh
n.=-..fOl..ILL 61P..-TH NMt.E OF MOTHER/F;:'.RE'NT
\-JE:. .. OECl.-'liE t'tlDEf.?EN;.LT'f or THE\.#{S,Qf HlE->7'J-JE Of t.'-l..IFW!"l;' TH
LEGA!.-OBJEC'lKll'lTQTH= M...'lF<i....C... ""':';'10 IH1S$>JAl<CE"C'f \.; "':;<..OWJ.El.'G'E
COfl.9DEI<Tl:.Lk.t.Rlil ...;>l'
1:X::. CU_RREtH L"'SJ
12t.., NAI..\E. OF PARTY B - FIRS1
I 25E TYPED NAI,lE cr NOTNN
1 OFFiCIALTITLE
I
I 2aB. (If CLERGY)
I
27[: COUNT'!' Ci' ..\ ....RRIAGE
I ?OC AFfiX NOTAAY. SEAL
I
1
, .:>.- iOE<EFORE ME ON:
.'{:1:
1
; I ' (MM/ODlCCYrl
. 'F'
2<E..AODREss.crTY, $'l"....rer;:::OyN1RY.,'O'ND LIP GODE
COJN1Y
CLERK
!?g.:., NAME-QF CClJNWCLERK ;298. SIGNATURE tF CLERH '.01'1 DEPUT\' CLERK
I "
Ie\' ;
I 20C',DATE ACCEPTED'FO!? REG\Sl"RAnOO
I
ST ATE.-QF C;,'J..!FORNIA., OEI;'-ARTl-"ENT OF HJ8L1C HER..n-l, OFFICE rr- "1T:.J.. F.lECCRDS
107
OR.ALTERA110NS
SlATE FILE I'JUM8ER
o PUBLIC o CONFlDENTlAL o DECLARED
Lqc.tlJ., REG"ISTRAi ION NuMBER
o NON-CLERGY
TYPE OR PRINT CLEARLY IN BLACK INK ONLY - THIS AMENDMENT BECOMES A PART OF THE OFFICIAL RECORD
l'c". N,!.lJv1E OF PARTY A-FIRST : 18. h-llDDlE
I LASI NAl',1EAS LIS:rED ON M.A.RRIAGECERT1FICATE 11D,PA"tY NI'J,'E.,lF DIFFERENT FROM 80X. Ie
::IS=SL-::'E-::D-----------
APPE.ARS
01'1 ORIGINAL
RECORD
4C CURRE:NT LAST NAl11c PS USTEu ON Mt\'I:(RIf'\GE CERTIFICATE ;-m. PART't' s:s BIRTH LAST DIFFERENT FROM BOX4C
5 ITEh..\
NUMBER TO BE

6. li,j(ORRE';T It-iFORMATI01:J THAT ,,,F'PEJ:'.RS ON DRIG:1NP..\.. RECOF;D 77, CORI<E(CTtl) I!;FOf'MP'TiON.-"&i!i .3,<,'>HO'ULC'N'PEP,R
US"IONE-
!1EMFER
UI'JE
t--+,'\-,-----------
REP-SON B,
FOR

19C DATE SIGNED--MMIDDICC','\' I9B..nrL8RELAT.IOHSHIP TP Pt8S0N. IN I
We, the undersigned, here'by certify under penalty of perjury that we have personal kn01Medge of the above facts and thai the
information given above is tme- and correct
SIGN/l:llRES HA. Slo?NATURE OF FIRS! PERSON
9D, f.lJ)DRESS -(STREET Al'lu NVMl?.ER:, CITY', STATE,_ ZIP

PERSONS
MUsT"GN
THIS FORM 10A. SIGNATl,lRt;,OF PERSDN 1108: TflLElRELATlONSH1PTO PI;RSOt-l 10<;:: pP..TE
TO CORRECT
AMARRiAGE f--___:,__,,-c:-==:-:::-c___:=:-:c:::-c=_=_====,----'-------------------'------------
l:eGOm 10D, ,oOtJRESS{STRE6l' ,.!l,hJD NUMBER, CITY, SlATE.: ZtP CODE)
STATElLOCAL 1.1. OFFICE OF STATE ORLOCAL REGISTRAR
REGISTRAR '
USEDrn.y
1'2' DATE ACCEPTEb FOR REGisTRATION
STATEOF C,hJ..IFO);'tJ1A, DEPf<,RTMEI'H oF' PUBLlC,HEt..LTH. OFF1GE OF VITPJ... RECORDS VS24C.(0612D03)
108
81ATEF lLE l'IUM8ER
FOR DENOMINATIONS NOT HAVlNG CLERGY
i"lUSt 86LEG.iBLE -t.:",.AKE NO ERASURES, 'hH1TEOUTS, OR-OTHER
USEDARK INK ONLY
16.};JIDDL.E
1C.CURREN'r L:..;lT
<1."# PREVo M.....P.RI.lo.GESl SRCoP 15A !.AST 1,1,!,RRI;>..GEISRDP B'r; l 5B, GAlE
. . I
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;-.-_"". "-"'__ ..... ,. :';,"'i.;",.......
. :;;.<x"'-""t
I .. !l.1t J,'Ii. 1" s.r",,,
AFPIOAVlT
\.is 1:23
:R,e':l, it${}
130
)116.. :SlATE OF fW'liff
I
I
lAo f,IAME OF CAc-OM-..f'I\".5l; iGlVi'.>lj
LICENSE ANO CERTIFICATE OF MARRIAGE
FOR DENOMINATIONS NOT HAVING ClERGY
Ml.!STeE1GIBlE-...JAAKE EAAsunl$s., WMlTGOO:r$, oR O"OiER Al ifW"nm-,s
GROOM
P\5.RSO!'}?;L
DATA
I$SU=: QAT: I;;:3a LICE'.HSE No. 1. UcEl'tSE EXPIRES J cOul...ry Of ISSUE l2:lE. f<...!..ue of COt,lf.:1Y
1,LD:C\t c..;,: i'.E....'" 1 I l.v.Wl"K, '1'6...... I (
AFFIDAViT I-- __,l \ l j
,ss",'" __
.
BRIDE
PERSONAL
(:lATA
1'V1.. N"'ME OF aRIDF.-F;>r$T "..wJ'U.f; 1nr; MAIDEN LAST IF'AMILYj OA.TE Of; ('lfrrrH
1 I
'4A RSDrnCf;; { '"l"COOE!l.tO 115 S,A,TEOFB:RTH
- ----=r=' \ I __ L.__
lil )o.t)OREGS-o- ;:"r:FtMJiT II HIA, usr MAAAV,Qr: 1iSS O...TE-l.>D"lT>t vo'"
--.1-0 OG\..TM 0 PlSSOlUT10h q {d,lN,AM:HT ,
"'A. USUAlD"",-mAT"'" \ ''''"U$u", ",,"J OF "'",",S'> OR 'NW.'"" .__..
mLL NAM!O. OF -....... ! 2113:. STATE 0<' 5;RfM :uA.. FUl..;L !.\;'l'l,)E:N t..... OF I Z:2!l. STATE OF Bt?.Tl1
I l
I 21C, erN. S.lArE NolO ZIP .coo;::
I
I 0=1"::::."'51......,1:: ANO ZJpc:::Ql:::;,"'.----
I I
P:-:c-------..-.--..-.----
wE. THE ...'5, HER.EaY CEF:"!lI''I' n....T WE V{ERs JOINED IN .__ .. __'_"_' _
\.'ul<'1'1-'1 w..,' n:,o...r;
'"----.---"'-.1"------.-..--' ..... ...-.- ..... IN ACCOROAN(;.= vJ;,H ,HE Fl:UiES- Af><O
CUSTOMS OF OUR FiEljGtDUS' SODE.JY 0 ..
CERTlf.l-
CATION

TO THE P.

FlEO;Jli'l"01 r.--
tv........ OF i.l)CM,m;G!5nv.?
t-
I-ZS-E!. Of OO'"\.1-W pF APrUCA.ffi.Q 31) "",n, ,':C:CE?TE!l FOR

VS 115
Rev. 6190
131
v
o
LICENSE AND CERTIFICATE OF
DECLARATION. OF MARRIAGE
NO ERJ.SURE:S., WMlTEC>!.J'rS-, OR OTHERAll:EMTIOHS
\YIFE
PERSOH,.t..L
-DATA
1':<1."1- C.1T'Y ! UPCQ!:>i;. I;'10. I,,;, !;jTA,rrOf' -
H\.:$SANO fiM),lUNG" .... 1 ;l\.....!io<'flt1': '? L 1 D",r'
.. ... I<B. .
Ic,cc,-', u"'s"'UAL"',-'o"c"'cu"'pcc, KIND Of' C*l lNOtJSTR;Y f9". li.VUC....nOH,
ilOB 0:';" fllRTli .....
___---+=,---====---,---,---,---_,---=-=='-'__-----,., (, " 1
.. __! ..._.__ RR'''' CAs' '''''''''' 'W. I'" e:;,'i,f,;.

1.u... 11 Zit' COtll:'j lAO, COU.. 1 S1r\1,.E.l)f ,SlRTj-l
".".. __.."""hY, 1 1 I ._.L " _ .
)". .... LAST M,<..flFIlAGE. BY' ! '''1I. !).... ...... t>
AfFiDAVIT
OF
HUSBAND
;.t<.ND-WiFE
7."JA.. YF........ iZ3B. \JCIONSE !-:<O. \::I:>G. .. \:<;:..0, CQON'N Or ! NM<.e cQU>.lT'f CU:OR>(
.' ,
,;."
:l:+A. ':Slc.N....n;RE: O!" ..W 1;.:48., :s;.lS.......TURS C.'F WIF!:

"'.
ST....TE OF
wE.. ....lKiVEt</,>,M{;O HI,'"fl-h"Y CE'-;'('JF1' TH"'T viE WlO.R "K)lN-ED is MARF\Vl.GE ON ---"',,,,7.,,---
... C.t.Ul'OAl'li ..... IN. ACCQRD-'#CE Wl'l't{ 1:HE. U.WS OF
C'ERTJF!
CATION
W,TNESSES :<:;:tl-.. SIGNAr>J.Re OF WfT'}:F..ss I NO ern'. -STA.TE ZIP coo.
:====,- -+===;:-:=::-:....._"H,WN. .. .. .._-_._.__._--
-(!W'O OF' ...... 'r...t,<;.s ....O'[>J'(ESS ,;:H.1O>;T...,.,O ""......m;;> JI -ZSG. C!n', STATE ;:IP CODE:
REOLJlfll':Dl p..
\f..'C".L 1ll!<lC,'l'l'.1I NA. Rf.lQ1Et'?'..,..1>.

l:'lQ, D... rt< 0"01\ RF.OST",A:I:3N
i
VS 116
Rev. 6/90
132
.. .. ---,------
... 'f...;'
000014
- - --
CQUi'(1)'

'W-"ii'!-'f;

... ..
'F':.r
liS 123
Re,/. 6::3-9:
133
....-.
ius. ST.l\1I: OF
. : '....... ;.
. :10:
I . J
l..AS'I: BY: . ! us. v.,Y. 'J
D [.l.9.T"Ji 0 i:HssoumON 0 Ai>lNl.i'-MENT[ :..-' . . . ... : .,'..... . .'
. .
.. ..... . ',' .. '.
\
)
.. .. C94NrY f-* ISS:S
..;
.
_ ""t>::.. ..'.'
VS 116
ReV. 1189
134
1140< ZJP CODE
1
HI). 'So $TA"('-OF
"It'.A.. lAS;- M"'nFllhCE t::NDE:O in":. 11l:lB. """"'''
! --------*"-
2;D. Or I,"GH"E:5T S?..... DE
C'Ot.. F'1..!;:'TEO ['l-,:i' 1:>--W1
LICENSE i<fib CERilFicATE OF MARRIAGE
MUST BE LE'-lI'it..:f_MAKS NO OrnE.R A!..TE.l"\A1"lOr{s
'BAIDE
I"ERSor-.!A.L.
DATA.
w:o.. ""11: UNDf.P.=I,lE.O. A.. U>IJ..l... AA\SO ).V;f.l.),.NDum,;{.<..RI'<It!.p \h"i.t-'J'. ... ....'ffi''''''T'rtiE fClH.Et,;.",!..lti lS;CC"\fl(,.GT Attb THE fltEl OF' -oU;o;X.':;:O->'>'LEOGf;.>.NO
n-lATtJO TO"T"rlf: t....... r.,s\;'''-l/'CE;or- J.UCfrlSElS KNOVrn TO "1"1").." FO" .... l.lc:...""N!r'iiAl<'O G!::l'\T1F'lc...:r;;: Of' u.'IFfi'll"'GE..
A.ffIDAVIT
....nor:l ANti Llt;.-,JSF.1S G:V&l TO ;'Uy(>t:f<s;Oli ::JuLY A.UTHC"C:W e'(''i"KE ;":'WS OF'-HE.Sr'ATE DFCAt.!f,Oft':M TO l"!:I'\l"iOf'M A.\,<..S<H:.-..GfO C",tlF.MORY \'>'i"I'''''''' H';!O :;T,<,n:
Cf' C....1FO!".>-liATO ....tI-O"'E.,N-..MEQ. "EP-,.<;o,<:o. F;l:"O:;,Jl?gl,ll:;:O"""filJlS THE 0': 'n"lSuca,'S':;:,AnlO O>{ r;LG..

I
I CITY, STATE: ;"j..!O Z,lf' CODE.:
I .
: "-;<.";:::C-:. Q:::,..,"',-=S"''':::T''',-C",:::c'C,:::,p:-co::::::o-::,----
I
"Ii<f.lE ANO- OFFlc::....... TITLE Of FEfU;O" sou;>a,,:z,1<; 1,l ....l'IfotIs.,GE.
rn'f'li: o,"."'/Ui'(T}
1255, LlCE,!'it.oE EXf\lRES- Ai'"'TER lJ(;.ENst ;,,;jUIlER
I ... I
I I _
iZSE. '.';lGt.tAJUR.l;: OF COUh!rt cLef'!'rt
I l'
I
"25A. DAn:
... o-"TH.!>J.........Aot
l,.JCENSE
TOMJ.,RRY'

OF' PERSON

t2(iA... OF
WiTl-l5SS!E$1 If>:
OI"E SlGH...Tl.>fi"',:::0'=":::0:::.':::5;"--------;-;,:::-==,---
2l!.. 1 Cf:Rr,FY T.rcA.T nt ....i30;.,EiJi.. 1!IT.l'.:lc )",,"0 CROOl.l
W,'l'U;. ..JOIt",!:'O fir ME. m .....,I'O;f<l.,ca'S \tJ 'HlTjo( ":"HF,
!...J..,....-:> OF 'Tl"l,e. Cl<.UFc;>f<w:l.....
VS117
Rev. 1/89
:.'.
:: ....
135
liCENSE AND CEj'rnFICAT'E OFCONFloERTtAL ~ $ ; A R R I A G ~
030754
136
DATA
G"R'.)OM

O....Tf
CERTIFICATE OF ltitGfS'TRY OF MA!HUAG
l:!...r .... 10 .......1'1''(". ... Ql. .........
un .......Kf' HO ALTr.t.qlDt<,; COl. r.?....5VRE!i-
r'" :<,t.l-\E 0'" GRO:..1101. nw';'!!"l.Ir, l.\"a:>LC1''''''''' \...1..';;,14 ...!>(C 1;' OFT<: (H' \lR1H ..."......" T...
..
f I
t:::.'"P?E',iE:N7 GPo (!CC,W,:I.t!C;;{ _-:-S:l.-- -_-..-.. "tiC"'.",Oi'O"-C""O"'i'(... "'D"',""W"'."',;-;,,'"',,""o
F
D". ... e-"r "'Hi'. Or OF (.;flOC>..... l;l,i ai" "IOllo,;:?

-----+.o;--=c;;==----::===---;-;o;==,J-!::;c-- --,,,,,,,,=,,,,,,,,,1=====_-
N,l.8( or rZ-& I.... ,.\! l p:1 I),..n:. or elR,TH. ",.. 'r'"
':01 ',k" .. ...$11!; "';,.... ... ...G"tliI6. .-.. \7 SfRTHl'"L,t.CF.
\!h 8rs,t<r;"H,:>;; Qf \.,!ttI1I'.-'PItff.> Ar.>t,Ii"[$';: . ..,.C< .... ,<'><';.,,.,.. "(OWN ilB<: .... <-,,'""" .....,....
I" i
, 1
,,< O(,,,rATi011 '"m 01 ,""'",<' OR .""",,, S, R, .. .,"c., ..
ho'iMf 01' r""BttR Of' B!-<lDE: ... - ..,,,,,,,,.... ,,.. .. -, v... I' . -- '"" "
>'1''$ -;:"'. Of E> ,f"f'"l':>G-1'''' I< a,Rl<l'('O't
1!.[',;:,<tI;lH> ::('!'-"<:.!lr'; FCfi TrlC; 'S$"JII"'Cf. T"',S lf.l'Ol." ......r. ClN r'LC
If:Jb.

\.2,=,"[. frf-'i!-t';'.nON 0,,1'1:: Of" ,-It:;"lit{::'l: I
.... ,.<,;;_,....2I....2----T:;;;.';_'. ....1H.'C;.:!i--.... ,."r."1 "", ..... "(.11"'- r;t>l ri:'I'....
l>' : :
Y-llTNE5$S "-'._'-'-.._-'_.. OF C;; 1,'.... '1 ;::;,'--;\;""11-
i"" : :
VS i17A
Rev. 7/86
137
, . LICENSE A"'!;) C.RTI1'lCATt:: ClF COHl"\DEN'IAl tAARRJAGE
A
.. 083316
.. ...__,_. .. .=-, ..__ .. ,. . _"
.... ..,,..,. lJS-f fit. ACK: Nt:) tI.t,.1f:Rt'nOr.r:; Of..: ,.- " ....
W;'
'.i!tlf l=-
, .-"". ".'''C'.'-_'''''
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...,." l' ;:,,-, <.-,,'>..r i\,' .;'.,:,....<;! ,_'1
c.', ...",-, ..,:,n,!, '1"-" :';.",
, .. ... (., .._j.. ''''''''';'''''''',!-''''' 1,..,.: .... ,
....." ,,.,..., >: <.of ' ...... "'.... _,-,.,. """, ' ..... >._ -,..,.. " '.... .1. , .;_ f: -. ,;'.f ...., ;, ,.j' ",>,", <,;4,.,-'<-,.{ "" ' . .-"',, r ,'l' I: :;:-.'" ,: '_'.
PI..EASE" aBrA.CHt THIS, SillS ;!.t..":fJ SEN.:O t1 W'i'TH thE. Cf.-BlrflEO COP''!' FEE ot:"
$: EACH COP" to 'r1-tE' COitJ}.,I:TY c;tx:nXQF 1"H'-( CO!J.NT"f QF tS$ul2".
\'S123
R:&,.t'1/M
138
4Q tM-i; tho" itl<b,..o,. 'hio:'!<$:
W,(:r.r'" .rt'I'<::<. t....\,..",.:. thl:I!.tlli;;:t':t ...u ,Df k!-'.... , b-)'
P,lj,;td to be... tn 4:z '):.:... Ct'l:'H
t 'r-=- -.,-
",""". __
:O-t
'I n
I
f:llt.. .1lo.HO ;J>"'M..;C,L1l-1..1l. -eOt.:ot. i$'i!:Cr...
:@.;...H! W1 ,(;of*,,"
VS 123
Rc-v 1,'54
139
c
(0
pS... Oft QC.cUPIo.'nCH
I . ....
r.i.... OF- FA, HER OF BRlDE
BRlOt:
p-E:RS0r.,'AL
DATA
GBOOM
?ERSON.AL
PATA-
CERTIFlCAn: OF \tEGfSTRY OF MARRfAGE
-si';;;:r'c-nU;.SUlolEF.R --- "{f>Efl;SC>I{Jr,L pA1A. tlCEt.. TO \.(Al"''f, ("..tR"tIF';CATloN OF MhRRlI,G.-i
NAME. OF llc, lJ'sr i-I-f.,,"IE
1 j
1 1
4. I1V1olflo(;tl ...;;tr:{5"'. _""la.J.-r {"toct>r .. G. lil"RTHf.lACf. ... f .....'.'...
l' "
Rf,S]O(N,Cl! Of' ...k"",.... ..",...._<"""",,,,<-.:.<,""" 17.:1'.. OR 'tOWN. 7{-7.c. CDUHn'
1 J
I J
rill. KiNO Of ItfOUSfR'l' OR OOSHH:SS ..
f MOTHER OF ..
------+.c"'C:.,.'H:u''''MS"'''OFC. --;1'"";;;,'""'","'",,,::0-:!;,::;,-:-,-::- "E 13 Of\'RTB',,"""
l'. ,,,,, ,"'." 115. NO"'''' 0)"''' je" "","., " ... .."." ,.,." _.,.,,,.
j1'!,/.- RES;tJENCE OF ... ,12.... 'C1T"l' DR TQY.'N C.nUrfr(
I I
.....,-:;;;;-;=-===.,-;;===-+';0== I
['" ",", I ::::::":::.:0::::,:
. -
1
".fFlDAVli
0;. BRIDE
ANO GROOM
UCENSE
T'O jJARRY
WfTt'lE$SES

OF -PE:R.SON'
Pg:?FORMING
CEfiE}oiO/:'l''''
W[, i'l-' ... );t>lt> ":"00"" NAIl(lllt\ 1HlS tA<:>i rOl'{ \i1.>lSELF. s::-,o,:rt nlliT nlE: !!t COlil;L't:11(f 01' ou" Mil;) lIU.!*,.
HI",,. t'lQ t-=:<;L.l, TO koll; TO 1"",' OF .. 1..ICl'tI'!;( Tv A.l.q'l'Iol?lZ:.t; 'J.lt: SAol/,>: t'i- ;<.lIp.....; :;0 u:;, ;,),'U M'l-'L'r ;"1< lll::f>;S( 'I;)
24:>., ?Rl0
tlf ,BE sr....n, QF C... A ..,C';"
l'Il'CUillf:O (:1l'NStfi1$ fort tKio: ;'.>::;'\;>.I\(".}; l;lF ,I'll::; ttCU;SE. Hlt Q'1 pU"
VS 117A
Rev. 6/81
140

1"'"''''''''-'''''''''
I
S Of TfiE: S'I-.)'I: OF' ru {,
r.lO'Jlr,to f"l;,Jl 'IHf. 1f,S'>.I>,';(;f. (.r i'll'S !-nr; ON nu:
OATI !-1(;.tNS( ....-, COlIIH\ elf":':
L..-._.__ )_.. .. ;11- _
'2"$.. D"'-H.: I?:>r, ((<I,lt"'y OF ;$5-1);; cr I ----
i' 1 !"ll>-
1
\ .... ._.__..
l!:ii, w' ,H!5 ...t;:1': 1 ,: .. L.. ... ! .. 'oi 17 "Bi1"T1-lPL,t.C(
I "'-- .
ClTV qR 'lOWH "=>u,.,.... ...
1 I
.--- 1 '
Z':) ;m__ SCH00L GRJ.lJ CO'"',fLETW Df
;::;;;::-E"'"iiiTH".ii!J,.It.,",.EQOfF,,"om"',"'
I"m"".".<>...... . ...
I
i 1"' B;l'lll:oE. l>'f'C')>\ '1}.'<I:r. 0.<:" H>k l'''i''ll.!.;!./. $T'>'1"I; l"OIH::C;OIN,. 1-;1'0<>......HO:< 1::t:""1'-CCl 'lC rio!:: "''<-it:';T KN(>WU'l'(,,: f,HD
:j{"r !'Oil ... 10 Till: !l.1-.'lIH;'.Cr. M,P. Til ,)-<t: '<'StJAlolti. .0, A llCEl'ist T'l .4.UlllCF:l::t 1l1L "i,llt 15 l"H;>WN ltl <:!;, 1'1.;\1 "OF. ... ""'r >;I'I"U: rGf<. ,0 J..!I'FI><\'.
CE'RTIFlCATE OF RiOGISTRY OF MARRIAGE
fa..! ..o.t D.o,"",,,. UCCNSr. TO C!':fl.Tlfl,:A,-nOI>l OF "'...

Of! !Ih-. >.tND Of ---- ---- -
i
UCE'.!".jSE
TO rr;;\RRY
ER1DE

DATf-.
GROOM
PE-R50Nkl.
DATA
AHIDp.vrT
OF l}-R1.[i'::::
'GR:OOl.l
26.... $IGNF.ltJ:{\O QJ"
WITNESSES
Or f..tmlll;!;S 1;;05c, APr*ESS OF \;tf:'l3$.,....-,.<,:'1'( 011 TaWIl ':""0 H.K,r;:
1 1
: --+:'. ..
!I- I :
I ,
T2"%. .... ..;;p'n;fT .o.OIlflE::lS. ,cln 01\ ..... STJI."",,
CERTIFlCATlON
-Of' P'I:RSOl">l
f2RFORMH<:G
CE"RE/f,ONY
\
1.,>- l Tb;,r THO:' ;>.t;QH 1',.... lO- \'l<II)( ;1.'I'J ,H)i!<8:> k'!' NE l?'i .u>". SlG.t.lATYflf.: Of Pl:fV'Ofi.I'.'Nq Gi('F';CI?,f,. nn..::;
.. 1(; f.O;;O<l.O'l"C 1;..: li>\<"S ('f ,"" 51Ft/;. ;)1"' >-
, 1-0,= .=. ..
.... _.18 ..
!
\'.'-
I.8C"'l f!1"!>I!0"RH, O":'.i ACCJ::PTF.O }'OR RE.C>I::;TBAT!n1'/
Q{' 1<-... .. r,s
lC::>V>lTffort.C!)'-'C'-'l\
LOCAL flE{;l$-TRAR
ill>-
VS 117A
Rev. 8(78
141
COWFlDEJ,fTtAL
RECORD OF CHURCH MAIl:RL"'-G
:.-:' '0;..: .'.', .....,
I; 1'.... \,.". <;t<'::'y,r. M: ..... " ,.., : .... "',,,,. ,..co;""'. ,.;.., ._
;.,--.c1-_.".-..;'..... . *."'''- w.-; 1;,o,:",'1,_c'" -." .. <> ,.,.........4'.
142
._-
..... ."- ... , >" _.',-0 ...
STAlE OF CALIFORNIA
DEPARTMENT OF HEALTH
OFFICE OF STATE REGISTRAR OF ViTAL
STATISTICS
CERlil'ICATl': OF REGISTRY OF MARRIAGE
)
(
GROot"
PERSONAL
\)A.TA

i}ATA
AFFlDAV1T
OF' BRiDE
AND GR()O","1,
LiCENSE
C2RTiFK;.:flcN
OF PERSON

CER!::h!CNY
()l1lASl' OR ,n.. . OF
I
!-;:-"'" ,-,Hc,cA",M"",""'O;='""c ,,"',,"'R""'D;='
"::
r
Gi'" WlTNC$S !2.5(. "OORDS OF co, 'L';',,,
I
,
1;... SrGIX.I\TDR2 OF WrrNr"$ !2:{t' ADOHESS OF ",'ITNC:;S'-tm tR !CWIl ,gl;! ST....r"
1'5_ I MtR""r,. CDfT'J"'r-j)j),r ,.-If. '\00'.'<' r,m:::f: ;,1<:1 .;:;<t\:V>< Wf..?l: ;!;i.'H';r., rr1 ;!, SlG.H"TURE c;: ?ER:5QN Pf3:FO?Ml}i{;. CEROJ.QIV'I' CiFFIC:,\!.. TITlE
!>< TilE L<.\iI'S br ,rU:' ....n; ::>Of C1.WfPi'I:."n;, ,-""-",, .... ,
__1._._. _
t,DDfl.S":iS j,Dt;nts:;. en on. y,;: ,,::: ':;:;;>.n:
:0O GlI'rF. ACcF.r1'ED FOtl Rf;GiSl'fj;i;11Gt<t
'Cl"Y.J,Rifl,,{;13
(COOllT!'lttl'll<:>t>:l
i..Cc;.l
l>-
VS ii/A
Rev. 4/74
143
STATE OF CALIFORNIA
DEPARTMENT OF HEALTH
OFFICE OF STATE REGISTRAR OF VITAL.
STAi!STICS
D.!l,'1/.:.
E ~ ; L ' E
;:Sf'':CN.t.,L
Form VS 117A
ReV,9i73
144
V::>l t<.J.t.t ,13 O;.rE OF
_
jiB>;. CHY OR T')Wf\ II,S>, CCB.,lNTY .,;"'...,.'''':('
1 I
l.zc tJ,tGllE;!;'r .
he. L.I..$T ....fOE
i I
CERTIFICATE OF REGISTRY OF MARRIAGE'
<PEF!.SONJ'"L Ucr.NSE: TO l<.ARSY. -':WMArlRlAGE)
\7", err1 OR CO\.lt'l'i"Y ...
I I
\ i
imm 0;:' lHDVSl:RY OR !>'JS1NESS _ C=OMPlET:.,
1-',,:..101{ JiAME OF hmTHiEp. OF GROOtA 11\1' l;lr(ll1r-vX;[ 'oF

I
3-. AGE ,:,"'!'"
14 AGE: .. .... ,""",...

I";::pjiESC"T 0" L"T CCCU"nO"J:" ""," de "">usT" OR "U''''Cs>
.. NAME: C.',? f..... 01'" 0l'1OE. ---"\Z"'2-,-",,-"l)'nw".7,-,-",,7, "NJ>."'"T''''Of=t,lO''''''H<''''('o'''f"''.''''::tln'''.

1
D-ATA.
BRIDE'

PERSONAL
DATA
A.FFlDAV!T
f>f
MW GROO:>.1
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AND
10' 6E'FORE ME ON
W.lT[-iESS-ES
LICENSE
"TO M.z"RRY
CERTlFICATION.
OF PERSml
PERFORMING
CR"EMotW
30. 01-. Tt IoCGFTEO FOR RG1STF.ATIOr{
O!'",A"Rl'\(i!$
"o;:.l.'11H
::p LOCAL REGISTftAR-SF.;t;!,r:JfI'io
l>
VS1i7A
Rev. ;,J1J72
145
GROOM
PRSON-AL
PAJA
BRJD:E;
PERSONAL
DATA
tV;. OF BR\D-E--f'ws'r,;A'li1O . 'I:::.

OR Ll\sr occuf'Ar:lc1l. "IRQ. OF QR lUI. h\A10!,' :"/l.ME Of l3RIL'E. If 7'RE'\'lO\..'SI. 'f lJ.ARtll.O
I
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i'll ..... GROOM (SlGN...:rt!REi
\201" j1:.:t-ti[ Of OF \20t U\l'fn,wlJ-C1. Or r"JHfiF. f"..... ....\ I.tMpttf N..... OF MOTHER Of 9RlD:"('"'' 1'11IT}\1"-...G.Ct. OF
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AFFlbAVIT
of BRlI)E
',ND GHOOM
L,lCE;NSE
TO t4ARRY
WlTNESSf'S
23". ..... d h';':1l1<;; h h.:r"b)' S"'cn r.o d.... \'f <I >loth 0 ri:z.<:"; by d ..: l" ..... or lh .. Si,t.<;: "'! ( ... ... \Q pq.(o>m _
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21... $!JIlSC;.P.JSED ;-lio SWORN UCEt{S NUMBER 23",. coUHTr CLERK
TO :E!:.fORE ME ON I
12sr, cblJlfrr or OF' Ul:t:}lSE 1

z'1..... (iF
I 6 NAh!t.- MID ADD.RESS OF f'ERS?tI PERFORMING ('IT?' ....ll'lf.
:'::;:IT!F1CJ\TION r. i ("I;for"l.. '
OF PERSON \
'ERFDRMlW3 1.= --
CEREMONY :<.711, TnU AJ>ID If' 01< 1.\!t<!STER

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q-r
COI>riTrJ<Eo:cft:>>:,,,j
DrllRT:-aerr OF rueUc HU.llH
\is 1'l7A
Rev. 9/15f61
146
l.OC.1U".

",__
(ERTlFlCATE OF Rl':GlSTRY OF MARRIAGE
(PERS01'lp,L OA'rA, L}CEliS:f. TO M;,RR'f. OF IMtllnAG)

rJJ-E.
..
'1\ ... Nr.Mt; or BnjoE'-nRSTHJ;y.C lUll..
;3. AGE ".'" --1"- COl.OR OR "'C' I.....", !"..
lJS-til.L OF ?-R1P;' -.Sl"ilut r"
GROOM
PERSON..I>.L
BR1DE
Pt;:?SOtiAL
DATA
D;\TA
to,. OR"CRT ",'us, OCCUPA"o" ""OEN "'ME 0> DRID"
ze,. ".I" 0' FATH'R OF .,CE r "'''HF'''' 0' ".",iC, Z" "Alo," "'"' OF "OT"'" 0' 'R'"T'''
AFF)C';W1T
OF BRIDS
AND GROOM
\;:I/e, 1I.,,: b,;d< [.,,:,M:\cd in :hh " .. d, f,,, !o'>nsc:l(, d'at the !o-r"'::l"i,,9' 111JoTTTl "Il<;>.i> 11" Ie d,e bot >:01 ",.,r k""wlt:d"e l-hd I;.d;o:J,
lh.. t !l0 [.,.9..1 ohilOcl;",n Ie; Ihe m'>'H(';"S" "tll h, ol \0 .. "fhof'tC \},t; H-'l"/'" to '-'I, M1d 1e:: . !O
24"', , ' . :<,25>, i';ROOl>\ ..
LiCEN5E
TO MABRY
WfTNESSES

OF PERSON
PERFORMING
.CERE"\tON",(
Ll--,C....t. j?,G.l'STF\."'1l.
or !o-I,o..P.p,I,\&'E$

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2.31<. 'V..c.. DAT LICENSE ISSUE.P i:::St, UCU,:sE. iZ5?, -cou tin'

;;:>1. ... , Slt;m.:ruFi:E; o' WITT:l'::SS
ill>
.1
STi'-.TE. Of 'cf,UFORNIA
VS 117.'\
Rev. 111160
147
4(1- iMM4 .l:h:<'.CSc,"':l1,l<j'
:3 w1.D..vzo,i:rt<4, a1> <0, m""",,"".S""
________ <0,114. _
h. y'''''''''''/1W 4_--+_--:=_"'=-__, '1.{:i)M::,.Il;Y aX
________-+ ' ,r"l4k).;,,'3' aJ
vs
148
;1ffilarrtage QIettifitate
g,tate of <!I:alifornia
<11
"J <J., iun..;",- <Mud!, K;t .tf\.
j, tRc Q __ JOl,,<4,<,1. 'rw."Wcj""
a,tt4 -- _
4A1. .lK." J"=<"= <4 ,c.Mld,i"S' c,x
<w.4 , _
\IS 118e (07/01/2008)
149
jJlf[artiage q[ertifirate
g,tatc of (([aUtontia
aX ,"AC(k,; a...,..I.Kc;,.t.tj'
of Q 11=14" J..1IJ...,di g:t i>f'Q.
({; t
P
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.,j . 1
1
.. <101 a.. .i..;t
tn. .tK" j",[..IJ,c-tta 4 at _
=.d. .. a _
VS 11Be (Q7/0Vl008)
150
YS 11Se (07J01.12t)08i
151
of California
joined in marriage
e county of
at
at
-----------------
Certifl2ate
'':'' :.:-;
i/"'"
l'1arri age
I hereby certify that OD -r.'+."2"+.'
Day Year
ia, authority of a
I, the undersigned, as a -=
of
--------;t_---'
license issued by the county
_____________ the presence
In the County of_-,-

-"
at _
Signature of Person Marriage
VS 113e (Q7.tl.11f2CQS}
152
xvm. SUPPLEMENTAL UPDATES TO MARRIAGE HANDBOOK
Supplemental Update Information
Additional information regarding marriages not contained in this handbook can be found at
the following sites:
Site:
Email
Date: Subject:
10/07/08 Announcing Marriage Licenses Sold Tables. Information may be
obtained at the following link: Information can be obtained at the
following site:
http://www.cdph.ca.qov/data/statistics/Pages/OH1RMarriageData.aspx.
153
EXHIBITC
ACL 08.-07 Ruiing by tIle California Supreme Court Regarding SEn,c-Sex \1a.niagcs
Sandoval, Alicia R. x6693
From: Roth, Karen (CDPHOOVR) tKaren.Roth@cdph.ca.gov]
Sent: Wednesday, May 28, 2008 12:15 PM
To: County Olerk/Recorders
Gc: Chief Deputy Registrars; CDPK CHS
Subject: ,t>.CL 08-07 RUling by the California Supreme Courl Rogarding Same-8m:
Page 1 ofl
To facilitate the county's implementation of the ruling of lhe Supreme Court Decfsion, In re Marriage Cases [Six
consolidated appeals), Case No. 8147999., the California Department of Public Health is attaching changes \0
existing California marriage forms.
The California Department of Public Health Is advised by COUI"ist;1 that tho California Supreme Court has until
dose of business on Monday, June 16,2008 to rule on any requests for re-hearing and that the Court of Appeal
will likely issue a writ consistent with the Supreme Court decision. Assuming no legal developments to the
contrary, the Department of Public Health will recognize the Court's decision as being in effect beginning June 17,
2008.. The new forms should be used by all counties beginning June 17, 2008. Should the Courts take other
action, additional guidance from the State Registrar w\ll be forthcoming.
As the Stale Registrar, the CDPH is responsible for prescribing and furnishing all record forms for use in birlhs,
deaths, fetal deaths, and marriages in California. The Reglstrar is also responsible for ensuring thaI these record
forms are used correcUy throughout the State.
Revision to the marriage certificates are highlighted for your information; however, the electronically genera:cd
forms should not contain highlights.
If you'have any questions regarding this matter, please contact your State Office of Vital Records Policy I\nalyst.
Thank you for your efforts to implement the Supreme Court ruling.
08-07 Updated Marriage Forms ACLpdf
V115 (6-08).DOC \1116 (6-08).DOC VS 117 (G-OIJ).DOC VS123 (6-08).doo VS24C (G-
08).doc
Linette T Scott, MPH
DCpUt\'
Health !nionnation and Strategic Planning
Caiff-orr,ia Dcparuncnt of Public Health

6/312008
PH
State of California-Health and Human Services Agency
,California Department of Public Health
MARK BHORTON, MD, MSPH ARNOLD SCHWARZENEGGER
Director Governor
.June 5, 2008 08-09
TO: COUNTY CLERKS
COUNTY RECORDERS
SUBJECT: UPDATE - RULING BY THE CALIFORNIA SUPREME COURT
REGARDING SAME-SEX MARRIAGES
This All County Letter (ACL) updates ACL 08-07 issued on May 28,
Introduction 2008, that addresses the recent California Supreme Court ruling
regarding same-sex marriages.
Consist8nt with the California Supreme Court's June 4th order that its
decision on same-sex marriage will be final at 5 p.m. June 16, 2008,
the California Department of Public Health's Office of Vital Records
directs county clerks to begin using the new state marriage license
forms at that time. If the courts take additional action, we will provide
further guidance to the counties as needed.
Although the forms become effective at 5:01 p.m. on June 16, 2008,
the court's ruling does not require counties to remain open after
normal business hours on that date.
Questions
Original signed by:
If you have any questions regarding this matter, please contact your
Policy/County Analyst.
Janet McKee
Deputy State Registrar and
C h i ~ f , Office of Vital Records
Center for Health Statistics - Office of Vital Records MS 5103 - P.O, Box 997410, Sacramento, CA 95899-7410
(916) 442-2684
Internet Address: www.cdph.ca.qov
State of California-Health and Human Services Agency
California Department of Public Health
MARK B HORTON, MD, MSPH
Director'
October 3, 2008
TO: COUNTY CLERKS
COUNTY RECORDERS
SUBJECT: CHANGE TO MARRIAGE FORMS:
ARNOLD SCHWARZENEGGER
Governor
08-15
License and Certificate of Marriage (VS 117) (Rev 11/2008)
Confidential License and Certificate of Marriage (VS 123) (Rev 11/2008)
License and Certificate of Declaration of Marriage (VS 116) (Rev 11/2008)
License and Certificate of Marriage for Denominations Not Having Clergy (VS 115)
(Rev 11/2008)
Affidavit to Amend a Marriage Certificate (VS 24C) (Rev 11/2008)
Effective November 17, 2008, County Clerks are required to begin
hilroduction using the enclosed new marriage license forms for all Public licenses,
Confidential licenses, Denominations not Having Clergy licenses, and
Declaration of Marriage licenses. The Affidavit to Amend a Marriage
Form (VS 24C) has also been revised and is enclosed. Effective
November 17, 2008, only the enclosed new forms may be used for
the issuance of marriage licenses in California.
The designation of Groom or Bride is now available but not required.
Revised
Marriage
License
Forms
Based on Health & Safety Code Section 102200, the OVR has
approved the enclosed marriage license forms.
The OVR will send all County Clerk offices a supply of the new paper
marriage certificates for use beginning November 17, 2008. If the
paper form is being used, the personal data for the applicants must be
typed.
Center for Health Statistics - Office of Vital Records MS 5103 - P.O. Box 997410, Sacramento, CA 95899-7410
(916) 442-2684
Internet Address: www.cdph.ca.gov
C H ~ N G E TO MARRIAGE FORMS
Page 2
Electronic
Forms
Approval
Process
Transmittal
form
Updated
Handbook
Pages
Questions
Original signed by:
OVR approval to electronically produce these marriage forms must
be obtained individually by each participating county. Any county
that does not obtain approval to electronically produce the new
forms must issue marriage licenses on paper forms provided by the
State until approval is obtained.
Please find enclosed copies of the new marriage forms and the
Protocol for submitting electronic marriage forms for approval.
The enclosed transmittal form should be used when forwarding
electronically produced forms to the state office for approval. The
electronically produced forms should be forwarded to the attention of
the appropriate Policy Analyst.
Revised pages to the Marriage Handbook will follow at a later date.
If you have any questions regarding this matter, please contact your
Policy/County Analyst.
Linette T Scott, MD, MPH
Deputy Director
Health Information & Strategic Planning Division
Enclosures
Protocol for Submitting
Electronic Marriage Forms for Approval
Health and Safety Code Section 102200. Record Forms. The State Registrar shall
prescribe and furnish all record forms for use in carrying out the purposes of this part, or
shall prescribe the format, quality, and content of forms electronically produced in each
county, and no .record forms or formats other than those prescribed shall be used.
Pursuant to Health and Safety Code Section 102200, the only forms that may be
eleCtronically produced and used to license a marriage in California are State approved
marriage license forms. Please take the following steps to proceed with approval to
electronically produce the current forms:
PAPER SPECIFICATIONS
1. All marriage forms must be printed on white 28-pound ledger stock. The
forms must be on acid-free archival paper.
'2. Paper size is 8 W' xii".
3. Counties approved to produce forms electronically shall purchase the
required paper stock identified above and distribute their own paper supplies.
FONTS AND DATA ELEMENTS
). The size and type of fonts used must be in compliance with specifications set
forth by the Office of Vital Records. Five to twelve point Arial fonts, as used
on the enclosed forms, are required for the new marriage forms
(Rev. 11/2008).
2. Strict adherence to the position layout of the data elements on the OVR forms
is required.
SUBMISSION TO OVR FOR APPROVAL
, 1. After electronic systems have been programmed to print the new marriage
forms, you must submit the attached transmittal sheet to OVR requesting
State approval to electronically produce the new forms. With this letter you
must submit five blank copies and five completed copies (data filled) of each
marriage certificate you plan to electronically produce. Also needed are
copies of the Privacy Notification and Instructions and Information sections
that are on the backs of the certificates. This information may be provided for
review by printing it on the backs of the appropriate certificates or on separate
sheets of paper. Each county is responsible for ensuring that the certificate
forms submitted for review have undergone inspection and quality control to
ensure that they are as nearly identical to the State forms as possible prior to
submission.
2. OVR will review your marriage forms and, if acceptable, will grant
authorization for your county to electronically produce the new forms.
3. If your marriage forms are not acceptable, OVR will advise of the changes
that are needed to make them acceptable. OVR will also request five copies
of the corrected certificate(s) both data filled and blank, and those sections on
the back (Privacy Notification and Instruction Section) that require a change.
Once your forms are acceptable, OVR will respond as stated above in Item 2.
Please be aware that OVR will approve each county individually, rather than providing
blanket approval fora vendor. It is the County's responsibility to work with their vendor
to ensure that each form generated by the county is acceptable to OVR.
State of California Office of Vital Records
Transmittal Form
for
Electronically Produced Marriage Forms
To: Office of Vital Records - MS 5103
P.O. Box 997410
Sacramento, CA 95899-7410
Attention: _
Policy Analyst
Approval is requested to electronically produce the following type of marriage certificate(s):
o License and Certificate of Marriage (VS 117)
q Confidential License and Certificate of Marriage (VS 123)
o License and CerLificate of Declaration of Marriage (VS 116)
o License and Certificate of Marriage for Denominations Not Having Clergy (VS 115)
q Affidavit to Amend a Marriage Certificate (VS 24C)
The attached marriage certificates have been electronically produced by:
(System Vendor)
I hereby certify that I have reviewed the certificate(s) for accuracy and iUthey is/are an exact
replica of the state issued form:
(Certifier's Name)
(Agency Name)
(Mailing Address)
(City, State, Zip Code)
(Telephone Number)
Attached are five blank copies of each type of marriage certificate and five completed copies
(data filled) for each type of marriage certificate being requested for approval.
State of and Human Services Agency

MARK BHORTON, MD, MSPH
Director
October 21, 2008
TO: COUNTY RECORDERS
COUNTY CLERKS
SUBJECT: BRIDE AND GROOM NOTATION ON CURRENT (06/2008)
MARRIAGE CERTIFICATES
ARNOl.D SCHWARZENEGGER
Governor
Concerns have been rais;:;;j about the timeframe and proposed methods for changing
the marriage forms to include the optional designation of "groom" and "bride" as
described in the All County Letter (ACL) issued October 3, 2008.
In consultation with the California Association of Clerks and Election Officials, the State
Registrar will implement the following change to current marriage forms (Rev 6/2008).
Effective October 27, 2008, counties are required to use the attached PDF fillable form
to identify the parties of marriage as Groom, Bride, or neither as each party wishes. The
parties to the marriage will be required to inform the County Clerk at the time they apply
for their marriage license whether they would like to be identified as Groom, Bride, or
neither. Based on the information collected at the time of the marriage license
application, the County Clerk will complete the PDF fillable form. The PDF fillable form
will be printed on the marriage license before it is issued to the couple.
The content of the PDF fillable form will appear above the text in the left margin of the
.form that reads "Party A's Personal Data" and above the text in the left margin of the
form that reads "Party B's Personal Data" and will add the following:
Optional: [] Groom D Bride
From this point forward, no new handwritten alterations will be accepted for
registration. Counties that receive hand written alterations to marriage forms
issued prior to the issuance of the official PDF fillable form should consult with
the State Registrar for directions.
Per the ACL issued October 3, 2008, counties have been directed to implement new
forms (Rev 11/2008) allowing the optional designation of Groom or Bride on November
17, 2008. If c.ounties are unable to make changes to their automated systems to
impiemerit the new marriage forms (Rev 11/2008), then they will be permitted to
continue use of the PDF fillable form in conjunctIon with the current marriage forms
(Rev6/2008).
Center for Health Statistics - Office of Vital Records MS 5103 - P.O. Box 997410, Sacramento, CA 95899-7410
(916) 442-2684
Internet Address: www.cdph.ca.gov
BRIDE AND GROOM NOTATION ON CURRENT (06/2008)
MARRIAGE CERTIFICATES
Page 2
Additional guidance regarding the new marriage forms to be implemented January 1,
2 0 0 ~ , will be forthcoming.
Please contact your Policy/County Analyst if you have any questions.
Sincerely,
Original Signed By:
Linette T Scott, MD, MPH
Deputy Director
Health Information and Strategic Planning
EXHIBITD
Sotelo, Alida R. x6693
- :Z ..=-=
--
From:
$"ent:
To:
<::c:
SUbject:.
Dear Clerks and Recorders:
Roth, Karen (CDPH-OOVR) <Karen.Roth@cdph.ca.gov>
friday, October 03, 2008 12:19 PM
County Clerk/Recorders
Scott, Linette (CDPH-HISP); Agurto, Tony (CDPH-HISP-CHS); McKee, Janet (CDPH);
Fisher, David (CDPH-CFHS); McKendry, Jane (CDPH-HISP); Sewart, Denise (CDPH-HISP);
Gonzalez, Theresa (CDPH-HISP-CHS); McKinney, Da'vvud (CDPH-HISP-CHS); Misuela,
Linda (CDPH); Strasser, Rochelle (CDPH); Matwiczak, Janice (CDPH-HISP-CHS); Cisco,
Yolanda (CDPH-CHS); Whitehead, laura (CDPH-HISP); Phillips, Tanya (CDPH-HISP)
Conference Call Regarding New f\t1arriage Forms
You are Invited to participate in a conference call regarding the new marriage forms. Please see details below,
Date: Friday, October 3, ?(\08
Time: 2:00 p.m.
Leader: Dr, Linette Scott
Toll free number: 888-810-8157
Passcode: 64542
LInette T Scott, 1''\0, MPH
Deputy Dlredor
Healt'l Informattoo and Slraleglc Pt"nning
California Department of Pub!lc HealU1
(916) 410-;'849
linette, aov
1
OVR Mailing Address Page 1 of 1
From:
Sent:
To:
Cc;:
Sandoval, Alicia R. x6693
. .:---"--------------.,-..-------------
Roth. Karen (CDPH-OOVR) [Karen.Roth@cOph.ca.gov]
Wednesday, June 04, 2008 4;16 PM
County ClerrJRecorders
Gonzalez, Theres'Cl (CDPH.HISP-CHS); McKinney, Oawud (CDPH-H1SP-CHS); Misuela, Linda
(CDPH); Strasser, Rochelle (CDPH): Janice (CDPH-HISPCHS); Barr, John
(CDPH-H1SP-CHS-PCS); Rolh, I<aren (CDPH-OOVR)
Subject: OVRMalHng Address
Importance: HJ9h,
REMINDER.: Please make. sure that marriage certificates sent priority (overnight) mail to our office are addressed
corraotly. Failure to do so will result in the deillJery being delayed. The correct address is as follp,vs:
California Department of Pub!lc HenHh
Office of Vital Records - MS 5103
1501 Capitol Avenve, Suite 71,1110
Si;1cramento, CA 95814
Our regular mailing address is:
OffiCe of Vita! Records - MS 5103
P,O.8ox 997410
Sacmmento, CA 95899-7410
Please contact your Policy Analyst if you have any questions. Thanks.
Karen J. Roth, Chief
Policy, CompHan}::8 & Standards SectIon
Offic'P of Vital Records
(916) 552-8161 telephone
(916) 323-2579 - fax
6/512008
Sotelo. Alida R. x6693
spa. e.-it lSP;;;;
From:
Sent:
To:
<;:c.::
Subject:
Hi Alicia,
Roth, Karen (CDPH-QVR) <Karen.Roth@cdph.ca.gov>
Friday, January 14, 201112:20 PM
Sotelo, Alicia It x6693
Armstrong, Jeff (CDPH-HISP-CHS); Peters, Diane (CQPH-HISP-CHS)
RE: minister wishing to perform his own wedding ceremony
a
Family Code 420(a) states that the "parties shall declare, in the physical presence of the person solemnizing the
marriage and necessary witnesses, that they take each other as husband and wife." Based on this code, persons
cannot perform their own mi::miage ceremonies.
Please let me know if you have additional questions. Thanks.
Karen J. Roth, Section Chief
Vital Records
Birth and Marriage Registration Section
(916) 552-8161 - telephone
(916) 323-2579 - fax
Karen. Roth@cdph.ca.gov
From: Sotelo, Alicia R. x6693 [mailto:soteloar@co.monterey.ca.us]
Sent: Friday, January 14,2011 e:19 PM
To: Roth
l
Karen (CDPH-OVR)
Subject: minister wishing to perform his own wedding ceremony
Hi Karen"
.' ..' Would you happen to know the code that prohibits a person (in our a he's a minister) from performing his own
wedding ceremony? He is asking that we prOVide him with code.
Thank you,
c
Alicia R. Sotelo
Assistant County Clerk/Recorder
Monterey County Clerk/Recorder's Office
831-759-6693
1
DECLARATION OF SERVICE BY MAIL
Case Name: Hollingsworth, et al. v. O'Connell, et al.
Case No.: S211990
I am employed in the office ofthe County Counsel, County of Monterey, which is the office
of a member ofthe California State Bar, at which member's direction this service is made. I
am over the age of 18 years and not a party to the within action. My business address is 168
West Alisal Street, 3
rd
Floor, Salinas, California.
On July 22, 2013, I served a true copy of the following document:
MOTION FOR JUDICIAL NOTICE IN SUPPORT OF PRELIMINARY
OPPOSITION TO PETITION FOR WRIT OF MANDATE OF TWENTY
RESPONDENT CLERK-RECORDERS
on the interested parties to said action by the following means:
[] (BY PERSONAL DELIVERy) By causing a true copy thereof, enclosed in a
sealed envelope, to be hand-delivered on the interested parties as shown below.
[V] (BY MAIL) By placing true copies thereof, enclosed in a sealed envelope, for
collection and mailing on that date following ordinary business practices, in the
United States Mail at the Office ofthe County Counsel, 168 West Alisal Street, 3
rd
Floor, Salinas, California, addressed as shown below. I am readily familiar with
this business's practice for collection and processing of correspondence for mailing
with the United States Postal Service, and in the ordinary course of business,
correspondence would be deposited with the United States Postal Service the same
day it was placed for collection and processing.
[] (BY FACSIMILE TRANSMISSION) By transmitting a true copy thereof by
facsimile transmission from facsimile number (831) 755-5978 to the interested
parties to said action at the facsimile number(s) shown below.
I declare under penalty of perjury under the laws of the State of California that the
foregoing is true and correct. Executed on July 22, 2013, at Salinas, California.
NAMES AND ADDRESSES OF EACHPARTY SERVED:
Andrew P. Pugno
LAW OFFICES OF ANDREW P.
PUGNO
101 Parkshore Drive, Suite 100
Folsom, California 95630
(916)608-3065; (916) 608-3066
andrew@pugnolaw.com
Attorneys for Petitioners
David Austin Robert Nimocks
Kellie M..Fiedorek
Alliance Defending Freedom
801 G Street, NW, Suite 509
Washington, D.C. 20001
(202) 393-8690
Byron J. Babione
James A. Campbell
Kenneth J. Connelly
1. Caleb Dalton
15100 N. 90
th
Street
Scottsdale, AZ 85260
(480) 444:-0020
bbabione@alliancedefendingfreedom.org
David J. Hacker
101 Parkshore Drive, Suite 100
Folsom, CA 95630
(916) 932-2850
Donna Ziegler
County Counsel
Office of County Counsel for County of
Alameda
1221 Oak Street, Suite 450
Oakland, CA 94612
(510) 272-6700
(510) 272-5020 fax
Attorneyfor Patrick 0 'Connell
David Prentice
County Counsel
Office of County Counsel for Alpine
County
Alpine County Administrative Building
99 Water St.
P,O, Box 387
Markleeville, CA 96120
(530) 694-2287 ext. 227
dprentice@alpinecounty,gov
Attorneyfor Barbara Howard
Bruce S. Alpert
County Counsel
Office of County Counsel for Butte
County
25 County Center Drive, Suite 210
Oroville, CA 95965
(530) 538-7621
balpert@buttecounty,net
Attorneyfor Candace J Grubbs
John T. Ketelsen
Interim County Counsel
Office of County Counsel for Colusa
County
1213 Market St.
Colusa, CA 95932
(530) 458-8227
(530) 458-2701 fax
Attorneyfor Kathleen Moran
Gretchen Stuhr
County Counsel
Office of County Counsel for
County of Del Norte
981 H Street, Suite 220
Crescent City, CA 95531
(707) 464-7208
(707) 465-0324 fax
Attorneyfor Alissia Northrup
Kevin Briggs
County Counsel
Office of the Fresno County Counsel
2220 Tulare Street, Fifth Floor
Fresno, CA 93721
(559) 488-3479
k. briggs@co.fresno.ca.us
Attorneyfor Brandi 1. Orth
Huston 1. Carlyle, JI.
County Counsel
Glenn
525 W. Sycamore Street
Willows, CA 95988
(530) 934-6455
hcarlyle@countyofglenn.net
Attorneyfor Sheryl Thur
Michael 1. Rood
Imperial County Counsel
Office of County of Imperial County
Counsel
940 W. Main St., Suite 205
El Centro, California 92243
(760) 482-4400
MichaelRood@co.imperia1.ca.us
Attorneyfor Chuck Storey
Theresa A. Goldner
County Counsel
Office of County of Kern County
Counsel
County Administration Building
1115 Truxtun Ave., 4th Floor
Bakersfield, CA 93301
(661) 868-3800
tgo1dner@co.kern,ca.us
Attorneyfor Mary B. Bedard
Colleen Carlson
County Counsel
Office of County Counsel for Kings
County
Kings County Government Center
1400 West Lacey Blvd.
Hanford, CA 93230
(559) 852-2468
Colleen .carlson@co.kings.ca.us
Attorneyfor Rosie Hernandez
Rhetta Kay Vander Ploeg
County Counsel
Office of County Counsel for Lassen
County
221 South Roop St., Ste. 2
Susanville, CA 96130
(530) 251-8334
RVanderPloeg@coJassen.ca.us
Attorneyfor Julie Bustamante
John Krattli
County Counsel
Office of County Counsel for Los
Angeles County
648 Kenneth Hahn Hall of
Administration
500 West Temple Street
Los Angeles, CA 90012
(213) 974-1811
(213) 626-7446 fax
Attorneyfor Dean C. Logan
Douglas W. Nelson
County Counsel
Madera
200 W. 4th Street, 4th Floor
Madera, CA 93637
(559) 675-7717
(559) 675-0214 fax
Attorneyfor Rebecca Martinez
Steven M. Woodside
County Counsel
Marin
3501 Civic Center Drive, Room 275
San Rafael, CA 94903
(415) 473-6117
Swoodside@marincounty.org
Attorneyfor Richard N Benson
Steven W. Dahlem
County Counsel
Office of County Counsel for Mariposa
County
5100 Bullion St.
P.O. Box 189
Mariposa,CA 95338
(209) 966-3222
Sdahlem@ll1ariposacounty.org
Attorneyfor Keith M Williams
James N. Fincher
Merced County Counsel
Office of County Counsel for Merced
County
2222 M S1. Room 309
Merced, CA 95340
(209) 3 8 5 ~ 7 5 6 4
j fmcher@co.merced.ca.us
Attorneyfor Barbara J Levey
Margaret Longo
County Counsel for Modoc County
Cota Cole Law Finn
457 Knollcrest Drive, Suite 130
Redding, CA 96002
(530) 722-9409
mlong@cotalawfinn.com
Attorney for Darcy Locken
Nicholas S. Chrisos
County Counsel
Office of the County Counsel County of
Orange
333 W. Santa Ana Blvd., Suite 407
Santa Ana, CA 92701
(714) 834-3303
(714) 834-2359 fax
Attorneyfor Hugh Nguyen
Gerald O. Carden
County Counsel
Office of County Counsel for Placer
County
175 Fulweiler Avenue
Auburn, CA 95603
(530) 889-4044
(530) 889-4069 fax
Attorneyfor Jim McCauley
R. Craig Settlemire
County Counsel
Office of County Counsel of Plumas
County
520 Main St., Room 301
Quincy, CA 95971
(530) 283-6240
csettlemire@countyofplumas,com
Attorneyfor Kathy Williams
Pamela J. Walls
County Counsel
Riverside
3960 Orange Street, Suite 500
Riverside, CA 92501
(951) 955-6300
pjwalls@co.riverside.ca.us
Attorneyfor Larry W Ward
JoIm F. Whisenhunt
County Counsel
Office of County Counsel of Sacramento
County
Downtown Office
700 H Street, Suite 2650
Sacramento, CA 95814
(916) 874-5544
whisenhuntj@saccounty.net
Attorneyfor Craig A, Kramer
Jean Rene Basle
County Counsel
Office of County Counsel for San
Bernardino County
385 N. Arrowhead Avenue, 4th Floor
San &ernardino, CA 92415-0120
(909) 387~ 5 4 5 5
(909) 387-5462 fax
Attorneyfor Dennis Draeger
Thomas Montgomery
County Counsel
San Diego
County Administration Center
1600 Pacific Highway, Room 355
San Diego, CA 92101
(619) 531-4860
thomas.montgomery@sdcounty.ca.gov
Attorney for Ernest J Dronenburg, Jr.
Dennis J. Herrera
City Attorney
Office of the City Attorney
City Hall, Room 234
1 Dr. Carlton B. Goodlett Place
San Francisco, CA 94102-4682
(415) 554-4800
(415) 554-4763 fax
cityattorney@sfgov,org
Attorneyfor Karen Hong Yee
Rita L. Neal
County Counsel
Office of the County Counsel for San
Luis Obispo County
County Government Center, Room D320
San Luis Obispo, CA 93408
(805) 781-5400
(805) 781-4221 fax
Attorneyfor Julie Rodewald
John C. Beiers
County Counsel
Office of County Counsel for San Mateo
County
400 County Center
Redwood City, CA 94063-1662
(650) 363-4775
jbeiers@smcgov,org
Attorneyfor Mark Church
Dennis Marshall
County Counsel
Office of County Counsel for Santa
Barbara County
105 E. Anapamu Street, Suite 201
Santa Barbara, CA 93101
(805) 568-2950
(805) 568-2982 fax
Attorneyfor Joseph E. Holland
OrryP. Korb
County Counsel
Santa Clara
70 W. Hedding St., East Wing, 9th Floor
San Jose, CA95110-1770
(408) 299-5900
orry.korb@cco.sccgov.org
Attorney for Regina Alcomendras
Brian Morris
County Counsel
Siskiyou
P.O. Box 659
205 Lane Street
Yreka, CA 96097
(530) 842-8100
bmorris@co.siskiyou.ca.us
Attorneyfor Colleen Setzer
Dennis Bunting
County Counsel
Office of County Counsel for Solano
County
675 Texas Street, Suite 6600
Fairfield, CA 94533
(707) 784-6140
(707) 784-6862 fax.
Attorneyfor Charles A. Lomeli
John P. Doering
County Counsel
Office of County Counsel for Stanislaus
County
1010 Tenth St., Suite #6400
Modesto, CA95354
(209) 525-6376
j ohn.doering@stancounty.com
Attorneyfor Lee Lundrigan
Ronald S. Erickson
County Counsel
Office of County Counsel for Sutter
County
1160 Civic Center Blvd., Suite C
Yuba City, CA 95993
(530) 822-7110
rerikson@co.sutter.ca.us
Attorneyfor Donna M Johnston
David A. Prentice
County Counsel
Office of County Counsel for Trinity
County
Cota Cole LLP
457 Knollcrest Drive, Suite 130
Redding, CA 96002
(530) 722-9409
(530) 623-9428 fax
countycounsel@trinitycounty.org
Attorneyfor Deanna Bradford
Sarah Carrillo
County Counsel
Office of County Counsel for Tuolumne
County
2 South Green Street
Sonora, CA 95370
(209) 533-5517
(209) 5335593 fax
counsel@tuolumnecounty.ca.gov
Attorneyfor Deborah Bautista
Leroy Smith
County Counsel
Office of County Counsel for Ventura
County
Hall of Administration
800 South Victoria Avenue,L/C #1830
Ventura, CA 93009
(805) 654-2580
Leroy.smith@ventura.org
Attorney for Mark A. Lunn
Robyn Truitt Drivon
County Counsel
Office of County Counsel for Yolo
County
625 CODit Street, Rm. 201
Woodland, CA 95695
(530) 666-8172
Robyn.Drivon@yolocounty.org
Attorneyfor Freddie Oakley
Angil Morris-] ones
County Counsel
Office of County Counsel for Yuba
County
915 8th St., Suite 111
Marysville, CA 95901
(530) 749-7565
amjones@co.yuba.ca.us
Attorneyfor Terry A. Hansen
Kamala D. Harris
Attorney General of California
Daniel 1. Powell
Deputy Attorney General
455 Golden Gate Avenue. Suite 11000
San Francisco, CA 94102-7004
(415) 703-5830
Daniel.Powell@dog.ca.gov
Attorneys for Real Parties in Interest
Edmund G. Brown, Kamala D. Harris,
Ron Chapman and Tony Agurto

S211990 Motion For Judicial Notice ISO Oppn To Writ - Part 2

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S211990 Motion For Judicial Notice ISO Oppn To Writ - Part 2

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