First Name:  Middle:  Last:  Suffix: 

Date of Birth: (Month  Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day  Year ) Age in Years: 

Home Phone: ()  - 

Current Address Number & Street:

City:  County:  State:  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Virgin Islands ZIP: 

Place of Birth, State or Country:  Occupation: 

Father's name:
First:  Middle:  Last:  Suffix: 

Mother's name:
First:  Middle:  Last (maiden name): 

Have you ever been married?  No Yes If yes, how many times 

First Name:  Middle:  Last:  Suffix: 

Date of Birth: (Month  Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day:  Year: ) Age in Years: 

Home Phone: ()  - 

Current Address Number & Street:

City:  County:  State:  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Virgin Islands ZIP: 

Place of Birth, State or Country:  Occupation: 

Father's name:
First:  Middle:  Last:  Suffix: 

Mother's name:
First:  Middle:  Last (maiden name): 

Have you ever been married?  No Yes If Yes, how many times? 

Name of the Officiant you expect to perform your marriage ceremony:

Is either party under guardianship? Yes No