Covenant Marriage Forms - Bienville Parish Clerk Of Court
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1
2
3COVENANT MARRIAGE
AFFIDAVIT AND ATTESTATION
STATE OF _________________________
PARISH OF _________________________
BEFORE ME, the undersigned Notary Public, personally came and appeared:
___________________________________ and _______________________________________
(Name of Bride)
(Name of Groom)
who being duly sworn, deposed and said that they received premarital counseling from
___________________________________, __________________________________________
(Name of Counselor)
(Title of Counselor)
which counseling included a discussion of the seriousness of covenant marriage, communication
of the fact that a covenant marriage is a commitment for life, a discussion of the obligation to
seek marital counseling in time of marital difficulties, and a discussion of the grounds for legally
terminating a covenant marriage by divorce or by divorce after a judgment of separation from
bed and board.
_____________________________________ _______________________________________
(Signature of Bride)
(Signature of Groom)
ALSO BEFORE ME, the undersigned Notary Public, personally came and appeared:
_________________________________________ who being duly sworn, deposed and said that
(Name of Counselor)
________ counseled the above man and woman as to the nature and purpose of marriage and the
(he/she)
grounds of termination thereof and provided a copy of the pamphlet entitled Covenant Marriage
Act to the couple entering into the Covenant Marriage.
______________________________________
(Signature of Counselor)
SWORN TO AND SUBSCRIBED BEFORE ME THIS _______ DAY OF
______________________ 20___
_______________________________________
(Seal and Signature of Notary Public)
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