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A IN THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL CIRCUIT IN AND FOR MIAMI-DADE COUNTY, FLORIDA IN RE: THE PETITION OF Luis dbyie 6, mene Ml monte case No.2 40 07084 cA0 1 {Write Party Name (s)} Petitioner C37) mw RS And GENERAL JURISDICTION 340). Karta ectsth ne Nayewyo wo {Write Party Name (s)} Petitioner 1SS /4 PETITION FOR CORRECTION OF RECORDICERTIFICATE OF MARRIAGE wo 4. Petitioners, £0¢5 Letereco Amenc, aes Keven tucdit, pene. Mewerr oO (Write name of Petitioner 1) (Write name of Petitioner 2) husband (or spouse) and wife (or spouse), were married in MMeame , Miami- (Write name of city) Dade County, Florida, on or/ay, Waa 20 poo 23. and are now residentsof _A7¢@ 7270 (Write name of city) Miami-Dade County, Florida. 2. Petitioners’ marriage license was issued on_|_ O 7/7 5/ 202.2 by the Clerk of the (Write date of issuance) Court in Miami-Dade County, Florida. The record of t heir marriage appears in the records of the office of the Clerk of the Courts in Miami-Dade County, Florida. 3. A certified copy of Petitioners’ marriage record is attached as Exhibit # 25506 3 , and (Write Exhibit number) incorporated by reference. Petitioners’ marriage record is erroneous as to the following facts: (Describe error on marriage certificate) AnSwer Them 2$. (weve You ever |Previos lg mavrid) ‘ = Yes Answer Ttem 29a. ( Number of thy mariage) 2 Anjwee ttem 296 (Last marriage \ended by Divarce« Pen Seu cw ttem 74 (dat. lect Mmarycage ondeg) m ay Bi~ AO/O ‘An. Jr Pasings and Pract Forms Anatted Vol 17A Mariage §31 2017 Page 1 of2 5. The erroneous facts in Petitioners’ marriage record should correctly appear as follows: (Write how the error should be corrected on the meetings serttheate) them ag? were You ever Prevos 4 parried Should Cex wectla | appear as, NO Litem Bfa NOs ofthis marries @ Should Corrects. 4 fypeor as: L Lem 296 last mavaasge ended by should Cometh appear ASiLeEFt Blanes because the petihoner 1s nyt divorce Tem 29e: Dole lect marnage ended Should Corsectle appear @5i Leaves Blen' becaus< the per huner hes Secg dimers JUL-25-2023 2; SS aS) 11. TITLE OF OFFICIAL 72. SIGNATURE OF OFFICIAL (Use black ink) q/ t{d Si 1} DEPUTY CLERK » MB evn Ky & ues| Se 43, SIGNATURE OF SPOUSE (Sign full name using black ink) 14, SUBSCRIBED AND SWORN TO BEFORE ME ON (DATE) 3 coon = JUL-25-2023 Sop we 18 ” Kacen Peta navetld 15. TITLE OF OFFICIAL 16. SIGNATURE OF OFFICIAL. (Use black ink) DEPUTY CLERK p Mithernge LICENSE TO MARRY "AUTHORIZATION AND LICENSE IS HEREBY GIVEN TO ANY PERSON DULY AUTHORIZED BY THE LAWS OF THE STA FATE'BE OFUSEDFLORIDA TO PERFORM A MARRIAGE CEREMONY WITHIN THE ON OR AFTER THE EFFECTIVE DATE AND ON OR BEFORE COUNT: vO ‘STATE OF FLORIDA AND TO SOLEMNIZE THE "THEMARRIAGE OF THE ABOVE NAMED PERSONS. THISIN LICENSE MUST EXPIRATION DATE IN THE STATE OF FLORIDA ORDER TO BE RECORDED AND VALID. Has ‘s ee 17. COUNTY ISSUING LICENSE. 18, DATE LICENSE ISSUED 18a. DATE LICENSE EFFECTIVE 19, EXPIRATION DATE fe JUL-28-2023 ‘SEP-22-2023 MIAMI-DADE JUL-25-2023 | 20a. SIGNATURE OF COURT CLERK OR JUDGE 20b. TITLE 20c. BY D.C. ee , ERK OF COURT AND COMPTROLLER NP. CERTIFICATE OF MARRIAGE THEREBY CERTIFY THAT THE ABOVE NAMED SPOUSES WERE JDINED BY ME IN MARRIAGE IN ACCORDANCE WITH THE LAWS OF THE STATE OF FLORIDA 1. DATE OF MARRIAGE (Month, Day, Year) 22. CITY, TOWN, OR LOCATION OF MARRIAGE SEAL Ju 2, 2033 Miamsr FO) OV LAA ‘23a. SIGNATURE OF PERSON PRRFORMING THE CEREMONY (Black ink) 23c. ADDRESS (of pers UpZE BEE CEELS ste 20 Nie AN Ams Flora 23742 23. NAME AND oa c en stamp) 24,“Ce TO CEREMONY ly, MILAGROSState of Florida > jotary Pu Commission # GG 977936 F WI (0 CEREMONY My Commission Expires 25. SIGt Thee as ne August 04, 2024 > INFORMATION BELOW FOR USE BY VITAL STATISTICS ONLY - NOT TO BE RECORDED 26. SOCIAL SECURITY NO 27. RACE 28. WERE YOU EVER IF ANSWER IS 'YES| TO ITEM 28. THEN COMPLETE ITEMS 29A, 29B, and 29C PREVIOSLY MARRIED? 29a. NO. OF THIS MARRIAGE 298, LAST MARRIAGE ENDED BY 29c. DATE LAST MARRIAGE, (Death, Divorce, or Annulment) ENDED 731-16-4330 a NO YES 2 DIVORCE MAY-31-2010 '30, SOCIAL SECURITY NO 31. RACE, 32. WERE YOU EVER IF ANSWER IS YES) TO ITEM 32. THEN COMPLETE ITEMS 33A, 338, and 33C PREVIOSLY MARRIED? ‘33a, NO. OF THIS MARRIAGE ‘3B, LAST MARRIAGE ENDED BY ‘3c, DATE LAST MARRIAGE. (Death, Divorce, or Annulment) ENDED 598-12-3595 NO a YES 4 DH Form 743, 01/2015. Florida Administrative Code Rule 64V-1.020 (Obsoletes Previous re