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Marriage License Online Form

  1. GROOM/FIRST PARTY
  2. (First Name)
  3. (Middle Name)
  4. (Last Name)
  5. (If different)
  6. (Month, Day, Year)
  7. (State or Foreign Country)
  8. 4a. Sex*
  9. First, Second, etc. (Specify above)
  10. 7. IF PREVIOUSLY MARRIED, LAST MARRIAGE ENDED
  11. 7a. By:
  12. (Month, Year)
  13. 8. RACE - American Indian, Black, White, Etc
  14. 9. EDUCATION
    (Specify only highest grade completed)
  15. BRIDE/SECOND PARTY
  16. (First Name)
  17. (Middle Name)
  18. (Current Last Name)

  19. (If different)
  20. (Month, Day, Year)
  21. (State or Foreign Country)
  22. 14a. SEX
  23. First, Second, etc. (Specify above)
  24. 17. IF PREVIOUSLY MARRIED, LAST MARRIAGE ENDED
  25. By:
  26. (Month, Year)
  27. 18. RACE - American Indian, Black, White, etc
  28. 19. EDUCATION
    (Specify only highest grade completed)
  29. NOTE:
    ITEMS 20 - 26 (SIGNATURES & LOCAL OFFICIAL INFORMATION) WILL BE FILLED OUT AT THE RECORDERS OFFICE ALONG WITH YOUR SOCIAL SECURITY NUMBERS WHEN YOU PICK UP YOUR MARRIAGE LICENSE
  30. CEREMONY
  31. (Month, Day, Year)
  32. (title -- i.e, Pastor, Reverend, Officiant)
  33. PARENTAL CONSENT
  34. (If Minor)
  35. (If Minor)
  36. (If Minor)
  37. (If Minor)
  38. (If Minor)
  39. (If Minor)
  40. NOTE: ITEMS 32 & 36 - 38, SIGNATURES OF PARENT OR LEGAL GUARDIAN AND SIGNATURE OF OFFICIAL WILL BE FILLED OUT AT THE RECORDERS OFFICE
  41. Leave This Blank:

  42. This field is not part of the form submission.