| Filed On | 4/13/2023 |
|---|---|
| File Number | 375706 |
| Type | Self Uniting |
| Applicant 1 | JENNIFER DAWN KELLETT |
| Applicant 2 | JOHN ROYDEN GYOURKO |
| County of Issuance | MONTGOMERY |
| Date Filed | 4/13/2023 |
| Filed By | LWayne |
| Date Issued | 4/16/2023 |
| Issued By | LWayne |
| Officiant Name | BERNARD KELLETT - ANDREW GYOURKO |
| Officiant Title | WITNESSES |
| Officiant Denomination | |
| Officiant Address | 3107 FOX DEN LANE OAKTON VA 22124 159 WEST MOBILE RD HARBINGER NC 27941 |
| Officiant Phone | |
| Date Duplicate Returned | 5/17/2023 |
| Received By | LWayne |
| County Married | MONTGOMERY |
| Where Married | GULPH MILLS |
| Date Married | 5/13/2023 |
| Both Speak English? | Yes |
| Interpreter Name | |
| Translate To | |
| Translate Date | |
| Clerk | |
| Issued Count | 0 |
| Micro Film | |
| Both Over 18? | Yes |
| Guardian Present? | No |
| Military? | No |
| Waiver? | No |
| Stipulation? | No |
| Outside Prohibited Consanguinity | No |
| Legacy | No |
| Related File No. |