Marriage Application

Personal Information

First Name *

Middle Name

Last Name *

Current Name Only if different from the name above.

Birthplace *

Date of Birth *

Age * Filled in from date of birth.

Sex *

Address

Street Address *

Address Line 2

City *

State *

Zip Code *

Marital Status

Domestic Status *

Number of Times Ever Married *

Name of Most Recent Spouse

Number of Times Ever in a Civil Union *

Name of Most Recent Civil Union Partner

Remarriage / Reaffirmation

For remarriage to the same spouse, or reaffirmation of a civil union with the same partner, enter the date and place of the original ceremony.

Original Ceremony Date

Original Ceremony Place

Parents

Father's Full Name *

Father's Birthplace *

Mother's Full Name *

Mother's Birthplace *

Additional Information

Are you related to Applicant B? *

Social Security Number *

Applicant A Information

Personal Information

Address

Marital Status

Remarriage / Reaffirmation

Parents

Additional Information

Applicant B Information

Personal Information

Address

Marital Status

Remarriage / Reaffirmation

Parents

Additional Information

Marriage Application

Ceremony Details

Contact

Proof of Residence

{{townType}} of {{town}}, {{state}} Contact Information