Marriage License Application

Your Names(*)

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Phone Number(*)

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Email Address(*)

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Your Full Address (You must state that you live together at this address)

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Mailing Address (if different)

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City and County Where Your Ceremony Is Taking Place

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Date of Ceremony

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FIRST PERSONS INFORMATION

What do You Prefer to be Listed As

BrideGroomNone Invalid Input

P1 First Name

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P1 Middle Name

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P1 Last Name

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P1 Last name at Birth (If Different)

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P1 Date of Birth (please use this format MM/DD/YYYY)

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P1 Place of Birth (enter first few letters of your State or Country of Birth)

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P1 Number of Previous Marriages

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P1 Last Marriage ended in (Select One)

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P1 Date Last Marriage Ended (MM/DD/YYYY)

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If your last marriage ended in the last 2 years you will need to show proof of dissolution

P1 Father's/Parent's Birth Name: First, Middle, and Last

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P1 Father's/Parent's Place of Birth (enter first few letters of His State or Country of Birth)

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P1 Mother's/Parent's Birth Name: First, Middle, and Last (MAIDEN NAME)

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P1 Mother's/Parent's Place of Birth (enter first few letters of Her State or Country of Birth)

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SECOND PERSONS INFORMATION

What do You Prefer to be Listed As

BrideGroomNone Invalid Input

P2 First Name

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P2 Middle Name

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P2 Last Name

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P2 Last name at Birth (If Different)

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P2 Date of Birth MM/DD/YYYY

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P2 Place of Birth (enter first few letters of your State or Country of Birth)

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P2 Number of Previous Marriages

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P2 Last Marriage ended in (Select One)

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P2 Date Last Marriage Ended (MM/DD/YYYY)

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If your last marriage ended in the last 2 years you will need to show proof of dissolution

P2 Father's/Parent's Birth Name: First, Middle, and Last

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P2 Father's/Parent's Place of Birth (enter first few letters of His State or Country of Birth)

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P2 Mother's/Parent's Birth Name: First, Middle, and Last (MAIDEN NAME)

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P2 Mother's/Parent's Place of Birth (enter first few letters of Her State or Country of Birth)

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Would either of you like to change your Name? Here is your Chance.

First Persons New Middle Name

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First Persons New Last Name

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Second Persons Middle Name

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Second Persons New Last Name

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Appointment Information

Have you set an Appointment With Us?

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What are you applying for?

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What Date, Time and Location did you want it issued?

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Would you like us to Perform your Ceremony too?

Yes - We Would Like You to Perform Our Ceremony
No - We Already Have an Officiant
Maybe - Tell me more Invalid Input

Additional Information or Questions

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Please Double Check and Make Sure All Entries are Correct(*)

IF ALL CORRECT CLICK THE BOX

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Confidential Marriage License Application

Marriage License Application

Address:

Phone:

E-Mail: