County Logo
Lynn Marie Goya
CLARK COUNTY CLERK
 

Document Details





Instrument Number
202205102002825

Record Date
5/10/2022

Book Type
NOT - NOTARIES

Book/Page

Instrument #
202205102002825

Number of Pages
4

Doc Type
OFF - MINISTER/OFFICIANT

Officiant Name
GORE, ROY T

Type
Single

Processed By
GARCIAB

Status
Approved

Online Test Passed
4/7/2022

Background Check Req?
False

Officiant Residence Address 1
824 SHADY OAK DRIVE

Officiant Residence City
SANTA ROSA

Officiant Residence State
CALIFORNIA

Officiant Residence Zip
95404

Mailing Address same as Residence?
True

Officiant Mailing Address 1
824 SHADY OAK DRIVE

Officiant Mailing City
SANTA ROSA

Officiant Mailing State
CALIFORNIA

Officiant Mailing Zip
95404

Officiant Phone 1
(209) 872-7710

Officiant Email Address
RTGORE91@GMAIL.COM

Ceremony Date
5/22/2022

Party 1 Name
NAKAMURA, NICHOLAS

Party 2 Name
ALLEN, HEATHER

Approved Date
5/10/2022

Certificate Expiration Date
5/23/2022

Renewal Notification Returned Date
1/1/1900

Notes
5/4/22 RECEIVED INCOMPLETE APP ON 5/4/22; PAGE 4 RECEIVED 5/10/22-BGG