Jeffrey S. Ketelsen
— and —
Jessica C. Mouton

29 November 2003



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First name: Jeffrey First name: Jessica
Middle name: S. Middle name: C.
Last name: Ketelsen Last name: Mouton
Age: 36 Age: 24
Address: 600 Pier I Address: 600 Pier I
Within city limits: Yes Within city limits: Yes
City: Lincoln City: Lincoln
State: NE State: NE
ZIP Code: 68528 ZIP Code: 68528
County: Lancaster County: Lancaster
Occupation: Manager Occupation: Student
Birthplace: Riverside, CA Birthplace: Houston, TX
Birth date: 05 April 1967 Birth date: 23 October 1979
Father: Douglas A Ketelsen Father: Gregory Mouton
Father’s birth place: Creston, IA Father’s birth place: Lafayette, LA
Mother: Carol R Johnson Mother: Sharon L Theriot
Mother’s birth place: Savula, IA Mother’s birth place: Lafayette, LA
Number of marriage: Second Number of marriage: First
Completed high school: 12 Completed high school: 12
College: 4 College: 4
Marriage ended why: Dissolution Marriage ended why:
Marriage end date: 15 051998 Marriage end date:
Race: White Race: White
Fee: 15
Staff: el
Marriage date: 29 November 2003
License ID: 2067