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Lynn Marie Goya
CLARK COUNTY CLERK
 

Document Details





Instrument Number
202302012000603

Record Date
2/1/2023

Book Type
NOT - NOTARIES

Book/Page

Instrument #
202302012000603

Number of Pages
3

Doc Type
OFF - MINISTER/OFFICIANT

Officiant Name
BURCH, JUSTIN D

Type
Single

Processed By
GARCIAB

Status
Approved

Online Test Passed
1/4/2023

Background Check Req?
False

Officiant Residence Address 1
917 NORTH DANVILLE STREET

Officiant Residence City
ARLINGTON

Officiant Residence State
VIRGINIA

Officiant Residence Zip
22201

Mailing Address same as Residence?
True

Officiant Mailing Address 1
917 NORTH DANVILLE STREET

Officiant Mailing City
ARLINGTON

Officiant Mailing State
VIRGINIA

Officiant Mailing Zip
22201

Officiant Phone 1
(571) 212-6792

Officiant Email Address
JDBURCH1@GMAIL.COM

Ceremony Date
3/4/2023

Party 1 Name
JERRETT, DANIEL

Party 2 Name
AUSTIN, MICHELLE

Approved Date
2/1/2023

Certificate Expiration Date
3/5/2023

Notes
2/1/23 PROVIDED SASE FOR RETURN MAILING-BGG