MARRIAGE LICENSE APPLICATION

City Ceremony Will Take Place

Date of Ceremony

1st Person ID or DL#:

2st Person ID or DL#:

(Expires)

Frist Name

Middle Name

Current Last Name

Last Name At Birth (If Different)

Date of Birth

State of Birth

Number of Previous Marriages/SRDP

Last Marriage/SR DP Ended By (1)

Death Divorce Annulment

Last Marriage/SR DP Ended By (1)

Death Divorce Annulment

Date Last Marriage/SRDP Ended

Father's Full Name

Father's State of Birth

Mother's Full Maiden Name

Mother's State of Birth

1st Person Address:

2st Person Address:

City

Zip

County

Mailing Address:

Email Address

Daytime Phone Number

New Middle Name (optional)

New Last Name (optional)

Packages