Form Of Power Of Attorney-California Marriage License

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_____________________

________________________

COUNTY OF STANISLAUS

STATE FILE NUMBER

LOCAL REGISTRATION NUMBER

POWER OF ATTORNEY: CALIFORNIA MARRIAGE LICENSE

[California Family Code 420(b)]

I _____________________________,

declare under penalty of perjury that I am a member of the Armed Forces

(Printed true legal name)

__________________________________

of the United States, who is stationed overseas in

and serving in a conflict or a

(Indicate where you are serving)

war and am unable to personally appear in the County Clerk’s Office to apply for and obtain a marriage license or participate in the

marriage ceremony. Therefore pursuant to Family Code 420(b), I hereby give Power of Attorney to

______________________________

to act on my behalf for the sole purpose of applying for and obtaining a marriage

(Printed Name)

license and participating in the solemnization of the marriage. I further declare that the true legal names of the parties to be married are

as follows:

____________________________________________________________

_______________________________________

(Printed true legal name of Party A)

(Date of birth MM/DD/CCYY)

____________________________________________________________

_______________________________________

(Printed true legal name of Party B)

(Date of birth MM/DD/CCYY)

____________________________________

________________________________________________________

(Date signed)

(Signature of person granting power of attorney)

Witnessed this _________ day of ___________________, 20_______

______________________________________________________

_____________________________________________________

(Signature)

(Printed name and Rank)

_______________________________________________________

_____________________________________________________

(Signature)

(Printed name and Rank)

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CERTIFICATE OF ACKNOWLEDGMENT

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the

document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of_____________________

County of ___________________

On_________________, before me, _______________________________________________, personally appeared

(date)

(printed name and title of officer authorized to take acknowledgments)

_______________________________________ who proved to me on the basis of satisfactory evidence to be the

(printed name of person )

person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in

his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s), or the entity upon behalf