Fillable MARRIAGE RECORD (County of Erie)

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MARRIAGE RECORD (County of Erie)

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Country of origin: US
File type: PDF

U.S.A. forms for County of Erie

BROWSE COUNTY OF ERIE (PA) FORMS

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MARRIAGE RECORD
For office use only
1. COUNTY ISSUING LICENSE
2a. WHERE MARRIED-CITY, BORO, TOWNSHIP
2b.COUNTY
3. DATE OF MARRIAGE
4a. NAME OF PERSON PERFORMING CEREMONY
4b. TITLE
4c. ADDRESS OF PERSON PERFORMING CEREMONY
(Street, City Of Town, State, Zip Code)
APPLICANT A
APPLICANT B
5. Full Name
14. Full Name
6. Mailing Address
15. Mailing Address
7. Residence
16. Residence
a. State
b. County
a. State
b. County
Location
Location
1. City of:
1. City of:
2. Borough of:
2. Borough of:
3. Township of:
3. Township of:
8. Occupation
17. Occupation
9. Date of Birth
Age
Sex
10. Birthplace
18. Date of Birth
Age
Sex
19. Birthplace
11a. Number of
Prior Marriages
11b. How and
When Dissolved
20a. Number of
Prior Marriages
20b. How and
When Dissolved
12. Cause(s) If Divorced
21. Cause(s) If Divorced
13. Education
College(1-4 or 5+)
22. Education
College(1-4 or 5+)
For office use only
Date License Issued (Month, Day, Year)
Date Report Sent (Month, Day, Year) To Vital Statistics
Signature of Clerk
Given and Surname of Father
Given and Surname of Father
Given and Surname of Mother
Given and Surname of Mother
Maiden Name of Mother
Maiden Name of Mother
Residence of Father
Residence of Father
Residence of Mother
Residence of Mother
Occupation of Father
Occupation of Father
Occupation of Mother
Occupation of Mother
Birthplace of Father
Birthplace of Father
Birthplace of Mother
Birthplace of Mother
Is applicant afflicted with any transmittable disease?
Is applicant afflicted with any transmittable disease?
Is applicant now under the influence of any intoxicating liquor or narcotic drug?
Is applicant now under the influence of any intoxicating liquor or narcotic drug?
Relationship of parties making this application, if any?
We, the undersigned, in accordance with the statements hereinabove contained, the facts set forth wherein we and each of us do
solemnly swear are true and correct to the best of our knowledge, information, and belief, do hereby make application to the Clerk of the
Orphans' Court of the above County, for a license to marry.
Signature of Applicant A
Sign only in front of a Marriage Clerk
Signature of Applicant B
Sign only in front of a Marriage Clerk
For office use only
Sworn and subscribed to before me this
day of
A.D.
Filed
Licensed Issued
(Clerk of Orphans’ Court)
(Seal)
No.
My Commission Expires
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MARRIAGE RECORD (County of Erie)

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Completed 5 August 2020

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