2. Important Information

   **Please complete form and print out prior to coming to the Clerk's Office. If you do not have a printer, feel free to complete the application at our office. **Both parties must be present with ID **Cost is $25 cash only

6. Applicant #1*
   Name (First, Middle, Last)
7. Applicant #2*
   Name (First, Middle, Last)
9. Date of Birth #1*
   Month/Day/Year
10. Date of Birth #2*
    Month/Day/Year
12. Phone Number #1*
    (xxx-xxx-xxxx)
13. Phone Number #2*
    (xxx-xxx-xxxx)
15. Current Physical Address #1*
    Street Address, City, State, Zip Code
16. Current Physical Address #2*
    Street Address, City, State, Zip Code
18. Mailing Address (if different) #1
19. Mailing Address (if different) #2
21. Place of Birth #1*
    City and State or City and Country
22. Place of Birth #2*
    City and State or City and Country
26. ***For Internal Use Only***
28. SSN #1
29. SSN #2
31. Book
32. Page
Leave This Blank:


33. Print Only

* indicates a required field