Prenuptial Questionnaire

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O
C
S
FFICE OF
ANONICAL
ERVICES
A
W
, P.O. B
29260, W
, DC 20017-0260
RCHDIOCESE OF
ASHINGTON
OX
ASHINGTON
T
: 301.853.5325
F
: 301.853.7674
E-
:
@
.
EL
AX
MAIL
CANONICAL
ADW
ORG
PRENUPTIAL QUESTIONNAIRE
GROOM
BRIDE
For Office of Canonical Services Use:
VISUM EST/NIHIL OBSTAT_____________________________________________________________
(SEAL)
Delegate of the Archbishop
Date
Wedding of:___________________+__________________at__________________________on_________
Last Name of Groom
Last Name of Bride
Name of Church or Other Place
Date
Each of the parties should be interviewed alone and under oath. The priest or deacon should propose the
questions and write the responses given. Please fill out separate forms for the Bride and Groom.
PERSONAL DATA:
Full Name:_____________________________________________ Occupation:_________________________
Address:______________________________________City________________________State____Zip______
How long at this address?_________ Phone_______________________ E-mail_________________________
Date of Birth___________________ Place of Birth________________________________________________
Religion_______________________ Parish______________________________________________________
Are you baptized?_____ If yes, in what religion?_______________________ Date of Baptism______________
Name/Address of Church of Baptism____________________________________________________________
(If convert) Date and Place of reception into Catholic Church________________________________________
(If Catholic) Have you received First Communion?______________________ Confirmation?______________
(If Catholic) Do you practice your religion regularly? (If no, explain)__________________________________
How long have you known your fiancée?______________________ How long engaged?__________________
Is this marriage a convalidation of an existing union?______________________________________________
Father’s Name___________________________________________________ Religion___________________
Mother’s MAIDEN Name__________________________________________ Religion___________________
Proposed Witness (Best Man/Maid of Honor)_____________________________________________________
MARITAL CONSENT:
Do you intend to enter a permanent, indissoluble marriage and be faithful to your spouse for life?___________
Do you intend to enter a marriage whose purposes are the mutual love and support of the spouses?__________
Do you intend to enter a marriage which is open to the procreation and raising of children?________________
Does your fiancée have the same intentions, to the best of your knowledge?_____________________________
(If any of the answers to the above questions is NO, please explain)____________________________________
Revised 05/2012

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