Document Details





Instrument Number
202310102005592

Record Date
10/10/2023

Book Type
NOT - NOTARIES

Book/Page

Instrument #
202310102005592

Number of Pages
3

Doc Type
OFF - MINISTER/OFFICIANT

Officiant Name
ROSALES, MYCAL L

Date of Birth
7/14/1983

Type
Single

Processed By
JAVELINO

Status
Approved

Online Test Passed
8/13/2023

Background Check Req?
False

Officiant Residence Address 1
3626 PORTICI LN

Officiant Residence City
HENDERSON

Officiant Residence State
NEVADA

Officiant Residence Zip
89044

Mailing Address same as Residence?
True

Officiant Mailing Address 1
3626 PORTICI LN

Officiant Mailing City
HENDERSON

Officiant Mailing State
NEVADA

Officiant Mailing Zip
89044

Officiant Phone 1
(702) 374-8254

Officiant Email Address
MYCALROSALES@GMAIL.COM

Ceremony Date
10/14/2023

Party 1 Name
BRADLEY, JEFFEREY O

Party 2 Name
DISKIN, EILEEN B

Approved Date
10/10/2023

Certificate Expiration Date
10/15/2023

Notes
ID VERIFICATION RECIEVED FOR PARTY1