Form Cu-3 Absentee Affidavit - Application Form For Civil Union -2013
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1ABSENTEE AFFIDAVIT – APPLICATION FOR CIVIL UNION
The absent party must fill this out completely, and the other party must bring the
affidavit and be present in order to obtain the license. A copy of the ID showing
proof of age of the absent party must also be presented with the affidavit.
STATE OF COLORADO
County of _________________________________________
I the undersigned hereby make application for a license to join in civil union and under oath I state that the information
given is true and correct to the best of my knowledge and belief and there exists no legal reason why we should not be
joined in civil union.
APPLICANT:
Legal Name: ______________________________________________________________________________________
First
Middle Name
Last
Previous Married Name OR Suffix
Address: _________________________________________________________________________________________
City / State / Zip
Number/Street
Birth Date: ______/_______/_______
Last name at birth if different (opt): ____________________________________
Social Security Number: ___________________________ City&State of Birth: __________________________________
Parent/Legal Guardian: _____________________________________________________City&State:________________
First
Middle Name
Last
Parent/Legal Guardian: ____________________________________________________ City&State:________________
First
Middle Name
Last
Present Marital/Union Status: (check one)
Single
Widowed
Divorced/Dissolved
Married
Civil Union
If Divorced/Dissolved/Widowed Date: ___/____/____ City&State: ____________________________________ Type of Court:_________________
Previous spouse/partner name:_________________________________________________________________
Proof of Age*: (check one)
Valid Drivers License
Passport
Birth Certificate
Other (specify) ______________
APPLICANT Signature: _________________________________________________
Subscribed and affirmed, or sworn to, before me this _____ day of ___________, 20____ at ______ __m.
(seal)
____________________________________________________________________
Notary Signature / County Clerk and Recorder / Deputy County Clerk
Affidavit by person to be joined in civil union when not appearing in person before county clerk. Properly executed, this
form upon presentation is attached to civil union license application.
*Proof of age must be presented to the County Clerk & Recorder at the time of application for a civil union license.
Form CU-3, Approved by the Office of the State Registrar of Vital Statistics, Revised 05/2013
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