First Middle Last (Maiden) First Middle Last (Maiden)   ) ( Phone Number: ) ( Phone Number: Zip Code: Gender: Zip Code:   mm/dd/yyyy mm/dd/yyyy     Highest Grade Completed: Previous Marriage Ended By: Number of this Marriage: Suffix (ie: Jr, Sr, III):

SPOUSE 1 INFORMATION

Age: State: First Name: Last Name: Maiden Name: County: City or Town of Residence: Current Physical Address
(no P.O. Boxes): Parent Name: Full Middle Name: Birth Date:     Highest Grade Completed: Previous Marriage Ended By: Number of this Marriage: Last Name:

SPOUSE 2 INFORMATION

State: Full Middle Name: Birth Date: Age: First Name: Maiden Name: Suffix (ie: Jr, Sr, III): County: City or Town of Residence: Current Physical Address
(no P.O. Boxes): Parent Name:
Note: Social Security Number is required for the issuance of a Marriage License. As a security measure, this information will be taken at the courthouse when the license is issued.                                            
Birth State or Foreign Country (use other): Birth State or Foreign Country (use other):
(if independent city, leave blank) First Middle Last (Maiden) First Middle Last (Maiden) (Street Address, City, State, Zip) (Street Address, City, State, Zip)

Use tab key (not enter key) to navigate through data entry fields

(if independent city, leave blank)
Officiant's Phone: (mm/dd/yyyy) Location of wedding: Officiant's Address: Officiant's name: Expected date of marriage:

 

 

 

Parent Name: Gender:

 

Gender:

Gender: Parent Name: Gender: Gender: