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Marriage License Application Form

  1. Name (First, Middle, Last)

  2. Name (First, Middle, Last)

  3. Month/Day/Year

  4. Month/Day/Year

  5. (xxx-xxx-xxxx)

  6. (xxx-xxx-xxxx)

  7. Street Address, City, State, Zip Code

  8. Street Address, City, State, Zip Code

  9. City and State or City and Country

  10. City and State or City and Country

  11. Important Information

    **Form must be complete **We will call you to set up an appointment **Both parties must be present with ID **Cost is $25 cash only

  12. ***For Internal Use Only***

  13. Leave This Blank:

  14. This field is not part of the form submission.