Transcription of MARRIAGE - DIVORCE - DEATH CERTIFICATE VIRGINIA …
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MARRIAGE - DIVORCE - DEATH CERTIFICATE VIRGINIA …
DL 82 (08-10-2019)AGE AT DEATH ORCERTIFICATION/DOCUMENT REQUESTEDDEATH CERTIFICATENUMBER OF PAPER COPIES REQUESTEDDECEASED NAME (print) - (first) (middle ) (last) (suffix) YEARS: DEATH LOCATION ( VIRGINIA city or county)HOSPITAL NAME (if appropriate)check one: PRINT FULL NAME (first, middle, last, suffix) MARRIAGE LOCATION ( VIRGINIA city or county)PLACE WHERE license WAS ISSUEDDIVORCE LOCATION ( VIRGINIA city or county)DATE OF DEATH (mm/dd/yyyy) DIVORCE DATE (mm/dd/yyyy) MARRIAGE DATE (mm/dd/yyyy) DIVORCE CERTIFICATEMARRIAGE CERTIFICATENUMBER OF PAPER COPIES REQUESTEDSEXFEMALEMALESEXFEMALEMALESEXFE MALEMALEBRIDEGROOMSPOUSEMAIDEN NAME check one: PRINT FULL NAME (first, middle, last, suffix)BRIDEGROOMSPOUSEMAIDEN NAMERACE OF DECEASEDLESS THAN ONE YEAR check one.
MARRIAGE LOCATION (Virginia city or county) PLACE WHERE LICENSE WAS ISSUED DIVORCE LOCATION (Virginia city or county) DATE OF DEATH (mm/dd/yyyy) DIVORCE DATE (mm/dd/yyyy) MARRIAGE DATE (mm/dd/yyyy) MARRIAGE CERTIFICATE. DIVORCE CERTIFICATE. NUMBER OF PAPER COPIES REQUESTED. SEX MALE. FEMALE SEX. …
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