Full Text
Application for Marriage License Applicant 1 Male Female FULL NAME First Middle Last ADDRESS Street City State Zip Code County Phone # DATE OF BIRTH AGE RACE BIRTH PLACE City/State OCCUPATION ARE YOU AND YOUR FIANCÉE RELATED? DESIGNATED SURNAME MAIDEN NAME (Are you changing your last name?) # OF PREVIOUS MARRIAGES (If none put zero SOCIAL SECURITY # *(If you’ve been married before, you must show proof of dissolved marriage: FINAL DIVORCE DECREE or DEATH CERTIFICATE) FATHER HIS STATE OF BIRTH First/Middle initial/Last MOTHER HER STATE OF BIRTH First/Middle Initial/ Last name at birth IN WHAT STATE DOES YOUR FATHER LIVE NOW? IN WHAT STATE DOES YOUR MOTHER LIVE NOW? YOUR WEDDING DATE LOCATION OF YOUR WEDDING City State County Applicant 2: Male Female FULL NAME First Middle Last ADDRESS Street City State Zip Code County Phone # DATE OF BIRTH AGE RACE BIRTH PLACE City/State OCCUPATION ARE YOU AND YOUR FIANCÉE RELATED? DESIGNATED SURNAME MAIDEN NAME (Are you changing your last name?) # OF PREVIOUS MARRIAGES (If none put zero SOCIAL SECURITY # (If you’ve been married before you must show proof of dissolved marriage: FINAL DIVORCE DECREE or DEATH CERTIFICATE) FATHER HIS STATE OF BIRTH First/Middle initial/ Last MOTHER HER STATE OF BIRTH First/Middle initial/Last name at birth IN WHICH STATE/S DO YOUR PARENTS LIVE TODAY? MOTHER FATHER The cost is $76. A discounted price of $36 is offered to couples upon completion of at least 6 hours of pre-marital counseling and the submission of the required certificate. Please inquire for details. RESET FORM SUBMIT FORM