Application For Declaration Of Nullity Of Marriage Due To Lack Of Canonical Form Page 3

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“I hereby confirm on Oath that I have answered the above questions truthfully. So help me God and these His Holy
Gospels which I touch with my hand.”
Signed: ________________________________________
Date:
__________________________________
Priest Witness:
_________________________________
Parish: __________________________________
CHECK LIST FOR PRIESTS:
Are the following documents presented to the Tribunal?
1.
Certificates – 3 – Baptism, Marriage, Divorce.
2.
Application for Dispensation (if new marriage is a mixed marriage).
3.
Proof mentioned in No. 26 above (if before 1949).
4.
Cheque for expenses - $150.00 – payable to ‘Tribunal of the Catholic Church.’
OFFICE USE ONLY:
In connection with this case, the following Certificates were supplied:
Certificate of Catholic Baptism of ____________________________________________________________________
Baptised at _________________________________________________ on ___________________________________
Certificate of Marriage _____________________________________________________________________________
Decree Absolute of Civil Divorce, granted at ___________________________________________________________
_______________________________________________________________on ________________________________
NO RECORD OF VALIDATION OR DISPENSATION FROM FORM
The records of the Archdiocese of Adelaide have been examined and there is no evidence of any Dispensation or
Retroactive Validation having been granted for this attempted marriage from _____________________________________
_____________________________________________________________until ___________________________________
Date: ___________________________________________
Signed: ________________________________________
Notary
I certify that information has been recorded from the Diocese(s) Parishes of:
That there is no evidence of the validation of this marriage, or of the granting of any Dispensation (including Dispensation
from Form) or Retroactive Validation in connection with it.
Date:
________________________________________
Signed: ________________________________________
Notary

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