Marriage License Request Information Sheet

LICENSE REQUEST INFORMATION

MARRIAGE OPTION:*
Groom or Bride (1st person on the marriage license) -*
IF NO MIDDLE NAME ENTER --
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)
Please enter Phone Number
If yes, how would you like to have your last name?
Groom or Bride (2nd person on the wedding license)*
IF NO MIDDLE NAME ENTER: --
MM/DD/YYYY
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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