i 2l_5

MARRI.AGE LICENSE DOCKET oF LACKA\I/ANNA COUNTV, PA.

*u/ YE{R. tso-f

M

APPLICATION FOR ARRIAGE.

l. Full name
2,
of thc man,
Full namc d the woman,
E
n
F^qb-'
/4. /42u2
3. Relatimship ol the parties, etther by blood or marlage,
4. Age ol thc man,
5. Agc of the woman,
5. Brthphcc of thc raan,
Birthplacc oI the woman,
8. Residcnce of thc man,
9, Residcncc of thc woman,
t0. Date of dcath of man's former uffe, iI any,
tt, Date ol dcath o{ wornan's formcr husband i{ any,
t2. Date of divorce of man at any timc, q, ,a,
13. Date of divorce of woman at any timc,
2)iz'e-221 br-/u/ /tc-.,.22 / 1z ?, .1 a-a/ t 2,, la
t4, Color of pardcr,
t5. Occupation oI man,
t6, Occupatlon of wotnan,
t/44:-
rV2z-zz-z--<-- -
t7. Do you or cither of you know of any legal irnpcdimcnt
to your being united, in marriage, if so what is tt? A4'2
f,aclnwanna 0o[nfy, !s.,

' 'Wlurcuy'ou, itquitl ladng bcoz oJ tlc said affh'cank alon oath, rclatiac lo lle kgality o/ said coilemflakd natiage azd no icgal im-
-nnd-c
pcdimcnt lltcrcto aly'carfug, a liccutc itt duc fonn o/ Iau, aulhorizing rcid rutiagc zuas issucd egruatly lo tAc frnisio)s o/ tte Ad o/ Asscn1ty it-wh casc
uade and prwidcd.

, lh. .nn.nl o/
nid conkmplalcd
,rarriage uat 16rsl giuen pcrwnallr 6c/ore mc (6y uilifiate du$r signed, allcslcd end and lllcd.)

.akrl O. C.

.flnd
.%.*..-
hutdred.-
"'-./- '" '---!-----F----tu'-'4"4 rl 't-'44""'Y-u...&'-.-
tn;t.d irt maniag. tu aardanu oith liasc is'sucd ly thc. Clcrh oJ fhc Orfhans' Cour!
rcluncd ard ftcd
/lllisl Signed.--

o. c.