NOTE: Both parents are required to sign this consent unless they either are divorced and one
parent was given SOLE parental responsibility of minor by a court order, or if the non-signing
parent is deceased.
CERTIFICATE OF CONSENT FOR MARRIAGE
STATE OF FLORIDA COUNTY OF CLAY
BE IT KNOWN, that We (I), the Parents (Parent) or Guardians (Guardian) of
____________________________________ (name of minor)(hereafter referred to as “Minor”)
who is seventeen (17) years of age, do hereby give our (my) consent to (his) (her) marriage to
____________________________________ who is not more than two (2) years older than Minor.
Only one parent is executing this affidavit based upon one of the following reasons:
Divorced and granted sole parental responsibility; or
Other parent deceased
Signature of Parent Signature of Parent
Printed Name of Parent Printed Name of Parent
Dated: Dated:
STATE OF FLORIDA
COUNTY OF CLAY
On this ___________ day of ____________, 20____, before me personally appeared
_________________________________to me known to be the person(s) who executed the foregoing
instrument, and acknowledged that (he, she, they) executed the same as (his, her, their) free act and deed.
Notary Public, State of Florida Seal
Personally known
Produced identification
Type of identification produced
