Document for winston fordyce VS Grace Lawrence-Fordyce

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                                        REPORT OF DIVORCE, ANNULMENT OR DISSOLUTION OF MARRIAGE * FORM 3907
                                                                                                                                             (REVISED 12/2016)
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                 PLEASE PRINT OR TYPE ALL INFORMATION LEGIBLY AND CORRECTLY BELOW.




   MILACTION NUMBER                                                 ‘DATE DECREE GRANTED (MONTH, DAY, EAR)          ‘COUNTY DECREE GRANTED


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   FIRST NAME OF PARTY E                             ‘MIDDLE NAME                                    TAME                        TASTNAMEAT BIRTH
   Winston                                            Emanuel                                        vdy CL,                       Eovdyce
   DATE
     OF BIRTH              DAY, YEAR)                               ‘COUNTYOF RESIDENCE                              NUMBER OF THIS MARRIAGE
                                                                                                                                          (RAST, SECOND, ETC)
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   FIRST NAME OFPARTY2
                                  RS                 MIDDLE NAME
                                                                          ekatl
                                                                                              TAST NAME,
                                                                                                                        2
                                                                                                                                             EATOIRTH
     AVA CL                                          Manan                                     Lawrence-Fordyee| |                               Verne’
   ‘DATE OF BIRTH [MONTH DAY, YEAR)                                 ‘COUNTY
                                                                       OF RESIDENCE                                  NUNIGEROF THIS MARRIAGE (FIRST, SECOND, ETC)
     0% -~-Z29- 1446                                                                           "NUMBER
                                                                                                 OF CHILDREN LESS THAN 18 AFFECTED
                                                                                                                              BY THIS DECREE
   ‘SPECIFY GROUNDS FOR DIVORCE (19-5-3, OCGA)
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  This above Report tray be reproduced by use of a computer. However, the finished Report
  must be a close reproduction of the original, and prior review and approval must be obtained
  from the State Registrar before use. (31-10-7, O.C.G.A.)
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                                   31-10-:              . Record of divorce, dissolutions, and annuiments.
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  {a) A record of each divorce, dissolution of marriage, or annulment granted by any court of
  competent jurisdiction in this state shall be filed by the clerk of the court with the department
  and shall be registered if it has been completed and filed in accordance with this Code section.
  The record shall be prepared by the petitioner or the petitioner's legal representative on a form
  prescribed and furnished by the state registrar and shall be presented to the clerk of the court
  with the petition. In all cases, the completed record shall be a prerequisite to the granting of
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  the final decree ! 1
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   (b) The clerk of the superior court shall complete and forward to the department on or before
   the tenth day of each calendar month the records of each divorce, dissolution of marriage, or
   annulment decree granted during the preceding calendar month.
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                                   |            'PLEASE ADDRESS ALL CORRESPONDENCE TO THE ADDRESS BELOW.
   STATE OFFICE OF            VITAL | RECORDS              | 1680 PHOENIX BLVD. SUITE 100, ATLANTA, GA 30349 | PHONE 404.679.4702
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