Department of Court Records Marriage License/Records 
                
 
Temporary ID: TEMP158172 Marriage License Application Form                       
 
All fields in red are required Applicant A Statement                                   
Last Name:
Suffix:
First Name:
Middle Name:
Maiden Name:
Date of Birth
(mm/dd/yyyy):
Age
0
 

Country of Birth:

State/Province of Birth:
 

City of Birth:
 

Sex:
Home Address:
Country:
 
State/Province:
 
 
City:
 
 
County:
 
 
Zip Code:
 
 
Occupation:
SSN: What's This?
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