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INSTRUCTIONS FOR AFFIDAVIT OF ABSENT APPLICANT PLEASE READ (Grimes County)

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GRIMES COUNTY CLERK
VANESSA BURZYNSKI
101 S. Main Street
Anderson, Texas 77830
(936) 873-4410
www.g
rimescountytexas.gov
INSTRUCTIONS FOR AFFIDAVIT OF ABSENT APPLICANT
If an applicant is unable to appear personally before the county clerk to apply for a marriage license, any adult person or
the other applicant may apply on behalf of the absent applicant. [
Family Code, Section 2.006]
PLEASE READ CAREFULLY: The applicant that will not appear in person to apply for the marriage license must
complete all blanks on the affidavit of absent applicant and sign the affidavit in the presence of a Notary Public. If all blanks
are not complete or the affidavit is not notarized it will not be accepted by the clerk.
The clerk may
not
issue a marriage license for which both applicants are absent unless the person applying on behalf of
each applicant provides to the clerk an affidavit of the applicant declaring that the applicants are :
1. A member of the armed forces of the United States stationed in another country in support of combat or another
military operation. [
Family Code, Sec. 2.006]
The person applying on behalf of an absent applicant shall provide to the clerk:
1. The party who will
not
be able to appear before the Clerk must complete and sign the Affidavit of Absent Applicant.
2. Names of both parties must be printed exactly as they appear on the identification used to obtain the Marriage License.
3.
An acceptable form of identification for the absent applicant may include any of the following:
[ Family Code 2.005(b]
•
State Issued
ID
Card
•
Valid Passport
•
Driver's License or Copy of Front and Back of License. (Must be legible)
•
Military ID Card or Copy of Front and Back of License. (Must be legible)
•
Copy of lnmate
ID
Card. (Must be legible and have date of Birth and I.D. Number)
•
Certified copy of Birth certificate and valid photo ID
4. Any altered document
will not
be accepted as proof of identity.
5.
The ID
for the absent applicant may be a legible photocopy.
6.
The
ID
for the party appearing before the Clerk must be original.
The fee for the marriage license is $82.00 cash or credit card. (No checks accepted.)
•
The notary must sign and seal the affidavit.
• The affidavit will expire 30 days from the date it is signed and notarized.
• The mar
riage license must be obtained within 30 days from the notarized date.
• The other party must ap
pear in the Clerk's office at least 72 hours but not more than 90 days prior to the ceremony.
• It i.s the applicant's responsibility to set up th
e appointment with the person who will be conducting the ceremony.
PROXY INFORMATION
The only absent applicants that can list a proxy on their affidavit are those that are a member of the armed forces of
the United States stationed in another country in support of combat or another military operation.
[F
amily Code. Sec.
2.007]
If
the absent applicant will be unable to attend the ceremony and he/she must appoint
one adult,
other than the other
applicant, to act as proxy for the purpose of participating in the ceremony. There can only be
one proxy
listed and cannot be
changed once the affidavit is notarized.
The proxy is not required to appear at the time the marriage license is issued.
WARNING: THE PENALTY FOR KNOWINGLY MAKING A FALSE STATEMENT CAN BE 2-10 YEARS IN PRISON AND A
FINE OF UP TO $10,000. (HSC, SEC. 195.003)
Revised 7/22/2015
Form No. D-02-41 (Rev. 07/22/2020)
OFFICE OF GRIMES COUNTY CLERK
VANESSA BURZYNSKI, COUNTY CLERK, GRIMES COUNTY, TEXAS
AFFIDAVIT OF ABSENT APPLICANT ON APPLICATION FOR MARRIAGE LICENSE
NAME:
First Middle Last Maiden Surname
(If Applicable)
ADDRESS:
Street Name & Number City State Zip Code
Date of Birth: Place of Birth:
Month/Day/Year City County State
Citizenship: Social Security Number
I have not been divorced by a Decree of a Court of this State within the last 30 days: □ True □ False
I am not presently married: □ True □ False
I am not presently delinquent in the payment of court ordered child support. □ True □ False
The other applicant is not presently married □ True □ False
The other applicant is not related to me as: an ancestor or descendent, by blood or adoption; a brother or sister, of the whole or half blood or by adoption;
a parent’s brother or sister of the whole or half blood or by adoption; a son or daughter of a brother or sister, of the whole or half blood or by adoption;
a current or former stepchild or stepparent; a son or daughter of a parent’s brother or sister, of the whole or half blood or by adoption.
□ True □ False
I agree to donate $5.00 to the Texas Home Visiting Program Trust Fund □ True □ False
I do desire to marry: □ True □ False
The party I desire to marry is
Age: Address:
Street Name & Number City State
Approximate date of marriage:
Month/Day/Year
Reason applicant is unable to appear personally before the County Clerk for the issuance of the license:
FOR MILITARY APPLICANTS ONLY:
If the absent applicant is a member of the armed forces of the United States stationed in another country in support of combat or another military
operation and is unable to attend the ceremony, the person appointed to act as proxy will be:
Signature of Absent Applicant
§
The State of Texas
County of Grimes
§
BEFORE ME, THE UNDERSIGNED AUTHORITY, On this day personally appeared
known to me to be the person whose name is subscribed to the foregoing instrument of writing and acknowledged to me that he/she executed
the same for the purpose and considerations therein expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE, On .
(Seal)
Notary Public in and for the State of Texas
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INSTRUCTIONS FOR AFFIDAVIT OF ABSENT APPLICANT PLEASE READ (Grimes County)

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Completed 13 February 2021

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