Get SC DHEC 0682 2008
F BIRTH 3. PLACE OF BIRTH (State/Country) 4. RESIDENCE (County, State/Country) 5. NUMBER OF THIS MARRIAGE - First, Second, etc. (Specify) 6. WIFE-MAIDEN NAME 9. RESIDENCE (First, Middle, Last, Suffix) (County, State/Country) 7. DATE OF BIRTH 8. PLACE OF BIRTH (State/Country) 10. NUMBER OF THIS MARRIAGE- First, Second, etc. (Specify) 11. PLACE OF THIS MARRIAGE (County, State/Country) 12. DATE OF MARRIAGE (MM/DD/YYYY) 13. PLAINTIFF 15. NUM.
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