Form A Pre-Nuptial Questionnaire printable pdf download

DIOCESE OF PENSACOLA-TALLAHASSEE

11 NORTH B STREET

PENSACOLA, FLORIDA 32501-4601

FORM A

(Revised 2/2006)

PRE-NUPTIAL QUESTIONNAIRE

Name of Groom_____________________________________Name of Bride___________________________________________

Social Security Number_______________________________Social Security Number____________________________________

Place of Marriage__________________________________________________Date of Marriage___________________________

Names of Witnesses_________________________________and____________________________________________________

(Each of the parties should be interviewed alone and under oath. The priest or deacon should propose the questions and write the

answers given.)

GROOM

1. Name__________________________________________________________________Phone Number____________________

2. Address________________________________________________________________________________________________

3. Date of Birth_________________Place_______________________________________________________________________

4. Occupation______________________________________________Religion_________________________________________

5. Father’s Name___________________________________________Religion_________________________________________

6. Mother’s Maiden Name_____________________________________Religion________________________________________

7. Parish in which you now reside______________________________________________________________________________

8. Length of residence in parish_______________________________________________________________________________

9. Have you ever been baptized?__________If yes, what Religion?___________________________________________________

Date_______________Church_________________________________Place________________________________________

10. Date of Confirmation_________________Place________________________________________________________________

11. (If convert) Date and place of reception into the Catholic Church___________________________________________________

_____________________________________________________________________________________________________

12. Have you ever been married before (either in church, civilly, or by common law)?____________(If “yes,” refer to box on back of

this page.)

13. Have you ever received Sacred Orders?________Or made perpetual vows in a religious institute?_____________If yes, please

explain:

______________________________________________________________________________________________________

14. How long have you been dating your proposed spouse?_________________________________________________________

15. Are you related in any way to her?__________________________________________________________________________

16. (If Catholic) Are you a practicing Catholic?______________If not practicing, please explain:_____________________________

_____________________________________________________________________________________________________

17. Are you giving your consent to this marriage voluntarily and without force of any kind?_________________________________

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Form A Pre-Nuptial Questionnaire