Date Marriage License Issued: No. _____________________
UNIFORM APPLICATION AND AFFIDAVIT FOR MARRIAGE LICENSE
IN THE 18th JUDICIAL DISTRICT
DISTRICT COURT OF SEDGWICK COUNTY, KANSAS
STATE OF KANSAS, _________________COUNTY SS:
APPLICATION MADE BY PARTY A PARTY B
Party A Name (Last Name, First Name, Middle Initial) City and County of Residence
Age (Please do not list date of birth.)
Party B Name (Last Name, First Name, Middle Initial) City and County of Residence
Age (Please do not list date of birth.)
PLEASE READ THE FOLLOWING:
The above-named parties hereby make application to marry and further apply for a marriage
license addressed to any person authorized by law to unite said parties in marriage. Affiant, being duly
sworn says:
That the contracting parties are of lawful age to obtain a marriage license, or have acquired the
necessary consent under law if they are not of lawful age.
That the contracting parties are not related to each other in any of the degrees prohibited by law,
to-wit: Parent and child, grandparent and grandchild in any degree, brother and sister of the whole or
half blood, uncle or niece, aunt or nephew, or first cousins.
That there is no legal reason preventing such marriage, to the best of the affiant’s knowledge and
belief.
Party A Signature Party B Signature
SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF, 20 .
Name and Title of Court Official
Fill out top po
rtion only; Do NOT sign the application
