Marriage License Request Information Sheet

LICENSE REQUEST INFORMATION

MARRIAGE OPTION:*
Groom or Bride (1st person on the marriage license) -*
IF NO MIDDLE NAME ENTER --
(IF OUTSIDE U.S. ENTER JUST THE COUNTRY)
LAST MARRIAGE / SRDP ENDED BY -*
IF UNKNOWN PLEASE PUT: UNKNOWN
(IF OUTSIDE U.S. ENTER JUST THE COUNTRY)
IF UNKNOWN PLEASE PUT: UNKNOWN
(IF OUTSIDE U.S. ENTER JUST THE COUNTRY)
If yes, how would you like to have your last name?
Please enter Phone Number
Groom or Bride (2nd person on the wedding license)*
IF NO MIDDLE NAME ENTER: --
MM/DD/YYYY
(IF OUTSIDE U.S. ENTER JUST THE COUNTRY)
LAST MARRIAGE / SRDP ENDED BY *
IF SAME OR WILL BE THE SAME AS 1ST PERSON ENTER SAME
IF UNKNOWN PLEASE ENTER: UNKNOWN
(IF OUTSIDE U.S. ENTER JUST THE COUNTRY)
IF UNKNOWN PLEASE ENTER: UNKNOWN
(IF OUTSIDE U.S. ENTER JUST THE COUNTRY)
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