I, the undersigned, do solemnly swear or arm:
• That I am eighteen (18) years old or older OR if I am under the age of eighteen (18) that I have parental, guardian, or
court waiver;
• That I am not aicted with any contagious sexually transmied disease OR if I am aicted with a contagious sexually
transmied disease that this fact is known to the other applicant;
• That I understand my marriage ceremony must take place between three (3) and 60 days from the date my marriage license is
issued to be valid and legal;
• That the following is true and accurate.
Oath - Must be read by both parties
Marriage License Application
Legal Name:
First Name Middle Name
Last Name
Date of Birth:
mm/dd/yyyy
Age:
Place of Birth:
Current
Address:
Street Address
City State Zip
Check any boxes that apply:
Single Divorced
Widowed Under control of a guardian
Signature of Party A
X
Subscribed and sworn before me this
day of
,
.
Signature of Deputy Auditor / Notary Public
Place notary seal here
Party A
Secon 1: Complete in legible print with blue or black ink
Secon 2: Complete in presence of Deputy Auditor or Notary Public
State (or country if outside USA)
Previous
Address:
Street Address
City State Zip
(if moved in last 6 months)
X
Party B
Legal Name:
First Name Middle Name
Last Name
Date of Birth:
mm/dd/yyyy
Age:
Place of Birth:
Current
Address:
Street Address
City State Zip
Check any boxes that apply:
Single Divorced
Widowed Under control of a guardian
Signature of Party B
X
Subscribed and sworn before me this
day of
,
.
Signature of Deputy Auditor / Notary Public
Place notary seal here
Secon 1: Complete in legible print with blue or black ink
Secon 2: Complete in presence of Deputy Auditor or Notary Public
State (or country if outside USA)
Previous
Address:
Street Address
City State Zip
(if moved in last 6 months)
X
Rev 11/19
