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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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