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Get Form Vs 300 Rev 01 2013

COMMONWEALTH OF KENTUCKY Form VS-300 Rev. 01/2013 STATE FILE NUMBER CABINET FOR HEALTH AND FAMILY SERVICES STATE REGISTRAR OF VITAL STATISTICS CERTIFICATE OF DIVORCE OR ANNULMENT MUST BE TYPED COUNTY Absolute Divorce Limited Divorce Annulment HUSBAND 1. NAME First Middle and Last 2. DATE OF BIRTH MM/DD/YYYY 2. a* AGE Last Birthday 5. Number of Times Married 7a* USUAL OCCUPATION 7b. KIND OF BUSINESS OR INDUSTRY 10. USUAL RESIDENCE City County and State /0 1/ WIFE 8. MAIDEN NAME First Middle and Last 13. RACE 11. PLACE OF BIRTH State or Foreign Country VE 15. PLACE OF THIS MARRIAGE County and State or Foreign Country 17. DATE OF DIVORCE OR ANNULMENT 6. RACE 18. NUMBER OF CHILDREN UNDER 18 16. DATE OF MARRIAGE MM/DD/YYYY 19. MAIDEN OR PREVIOUS NAME RESTORED YES NO C ATTORNEY FOR PLAINTIFF TI INFORMATION IN ITEMS 1-16 INCLUSIVE AND ITEM 18 FURNISHED BY PETITIONER S ATTORNEY UNDER PROVISIONS OF KRS 213. 116 4 SIGNATURE Black or Blue Ink Typed Attorney Name FE ATTORNEY STREET ADDRESS EF CITY STATE ZIP CODE PHONE NUMBER I THE UNDERSIGNED CIRCUIT COURT CLERK OF COUNTY HEREBY CERTIFY THAT THE ABOVE NAMED PERSONS WERE GRANTED ABSOLUTE DIVORCE LIMITED DIVORCE OR ANNULMENT BY A JUDGMENT OF THE COUNTY CIRCUIT COURT ON THE DAY OF 20 SAID JUDGMENT BEING RECORDED Circuit Court Case Number SIGNATURE OF CIRCUIT COURT CLERK Black or Blue Ink. NAME First Middle and Last 2. DATE OF BIRTH MM/DD/YYYY 2. a* AGE Last Birthday 5. Number of Times Married 7a* USUAL OCCUPATION 7b. KIND OF BUSINESS OR INDUSTRY 10. USUAL RESIDENCE City County and State /0 1/ WIFE 8. MAIDEN NAME First Middle and Last 13. KIND OF BUSINESS OR INDUSTRY 10. USUAL RESIDENCE City County and State /0 1/ WIFE 8. MAIDEN NAME First Middle and Last 13. RACE 11. PLACE OF BIRTH State or Foreign Country VE 15. PLACE OF THIS MARRIAGE County and State or Foreign Country 17. RACE 11. PLACE OF BIRTH State or Foreign Country VE 15. PLACE OF THIS MARRIAGE County and State or Foreign Country 17. DATE OF DIVORCE OR ANNULMENT 6. RACE 18. NUMBER OF CHILDREN UNDER 18 16. DATE OF MARRIAGE MM/DD/YYYY 19. DATE OF DIVORCE OR ANNULMENT 6. RACE 18. NUMBER OF CHILDREN UNDER 18 16. DATE OF MARRIAGE MM/DD/YYYY 19. MAIDEN OR PREVIOUS NAME RESTORED YES NO C ATTORNEY FOR PLAINTIFF TI INFORMATION IN ITEMS 1-16 INCLUSIVE AND ITEM 18 FURNISHED BY PETITIONER S ATTORNEY UNDER PROVISIONS OF KRS 213. MAIDEN OR PREVIOUS NAME RESTORED YES NO C ATTORNEY FOR PLAINTIFF TI INFORMATION IN ITEMS 1-16 INCLUSIVE AND ITEM 18 FURNISHED BY PETITIONER S ATTORNEY UNDER PROVISIONS OF KRS 213. 116 4 SIGNATURE Black or Blue Ink Typed Attorney Name FE ATTORNEY STREET ADDRESS EF CITY STATE ZIP CODE PHONE NUMBER I THE UNDERSIGNED CIRCUIT COURT CLERK OF COUNTY HEREBY CERTIFY THAT THE ABOVE NAMED PERSONS WERE GRANTED ABSOLUTE DIVORCE LIMITED DIVORCE OR ANNULMENT BY A JUDGMENT OF THE COUNTY CIRCUIT COURT ON THE DAY OF 20 SAID JUDGMENT BEING RECORDED Circuit Court Case Number SIGNATURE OF CIRCUIT COURT CLERK Black or Blue Ink. NAME First Middle and Last 2. DATE OF BIRTH MM/DD/YYYY 2. a* AGE Last Birthday 5. Number of Times Married 7a* USUAL OCCUPATION 7b. KIND OF BUSINESS OR INDUSTRY 10. USUAL RESIDENCE City County and State /0 1/ WIFE 8. MAIDEN NAME First Middle and Last 13. RACE 11. PLACE OF BIRTH State or Foreign Country VE 15. PLACE OF THIS MARRIAGE County and State or Foreign Country 17.

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