Document Details





Instrument Number
202102102000818

Record Date
2/10/2021

Book Type
NOT - NOTARIES

Book/Page

Instrument #
202102102000818

Number of Pages
3

Doc Type
OFF - MINISTER/OFFICIANT

Officiant Name
MOOIBROEK, MICHAEL

Type
Single

Processed By
COOKP

Status
Approved

Online Test Passed
1/3/2021

Background Check Req?
False

Officiant Residence Address 1
4365 DUCK HARBOR AVE

Officiant Residence City
NORTH LAS VEGAS

Officiant Residence State
NEVADA

Officiant Residence Zip
89031

Officiant Mailing Address 1
4365 DUCK HARBOR AVE

Officiant Mailing City
NORTH LAS VEGAS

Officiant Mailing State
NEVADA

Officiant Mailing Zip
89031

Officiant Phone 1
(440) 452-9131

Officiant Email Address
MDMOOIBROEK@GMAIL.COM

Ceremony Date
3/13/2021

Party 1 Name
RIVERA, PETER

Party 2 Name
JOHNSTON, EMILY

Approved Date
2/10/2021

Certificate Expiration Date
3/14/2021