| First name: Rick |
First name: Terri |
| Middle name: D. |
Middle name: Ann |
| Last name: Chmelka |
Last name: Burbach |
| Age: 25 |
Age: 22 |
| Address: Rt 1 Box 215 |
Address: 4428 No 7th Street #104 |
| Within city limits: No |
Within city limits: Yes |
| City: Valparaiso |
City: Lincoln |
| State: NE |
State: NE |
| ZIP Code: 68065 |
ZIP Code: 68521 |
| County: Saunders |
County: Lancaster |
| Occupation: Manager |
Occupation: Receptionist |
| Birthplace: Lincoln, Nebraska |
Birthplace: Osmond, Nebraska |
| Birth date: 25 June 1969 |
Birth date: 20 August 1972 |
| Father: James Chmelka |
Father: Allen Burbach |
| Father’s birth place: Brainard, Nebraska |
Father’s birth place: Yankton, South Dakota |
| Mother: Marilyn Shonka |
Mother: Barbara Wattier |
| Mother’s birth place: Surprise, Nebraska |
Mother’s birth place: Yankton, South Dakota |
| Number of marriage: First |
Number of marriage: First |
| Completed high school: 12 |
Completed high school: 12 |
| College: |
College: 1 |
| Marriage ended why: |
Marriage ended why: |
| Marriage end date: |
Marriage end date: |
| Race: White |
Race: White |
| Fee: y |
| Staff: mk |
| Marriage date: 25 March 1995 |
| License ID: 253 |