Application And Affidavit Template For Marriage License (Applicant A)
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1Date of Application
Date License Valid
Marriage License No.
Application and Affidavit for Marriage License (Applicant A)
State of WASHINGTON
County of Clallam
I, the undersigned, do solemnly swear or affirm, that the information on this form is true: that I am eighteen years of age or older or qualify as
designated below; I do not have any contagious sexually transmitted disease, or if so, the condition is known to the other applicant; that I am
not related to the other applicant; and, further, that I do not currently have a spouse or a registered domestic partner other than the other party
to this marriage. Marriage license is not valid for 3 days from date of application and is void if marriage is not solemnized in the State of
Washington within sixty (60) days of issuance of license.
Birth Date __________ Age _____ Birth Place______________________________ ___________________________
(Check One) Single
Widowed
Divorced
Under Control of Guardian
Male
Female
Address Present ________________________________________________ County ________________
Address Past Six Months _________________________________________ County ________________
Name _______________________________________________________________________________
Signature ____________________________________________________________________________
Deputy Auditor/Notary Public _____________________________________________________________
Subscribed and sworn to before me on this ________ day of ______________________, _____________
Application and Affidavit for Marriage License (Applicant B)
State of WASHINGTON
County of Clallam
I, the undersigned, do solemnly swear or affirm, that the information on this form is true: that I am eighteen years of age or older or qualify as
designated below; I do not have any contagious sexually transmitted disease, or if so, the condition is known to the other applicant; that I am
not related to the other applicant; and further, that I do not currently have a spouse or a registered domestic partner other than the other party
to this marriage. Marriage license is not valid for 3 days from date of application and is void if marriage is not solemnized in the State of
Washington within sixty (60) days of issuance of license.
Birth Date __________ Age _____ Birth Place______________________________ ______________________________
(Check One) Single
Widowed
Divorced
Under Control of Guardian
Male
Female
Address Present ________________________________________________ County ________________
Address Past Six Months _________________________________________ County ________________
Name _______________________________________________________________________________
Signature ____________________________________________________________________________
Deputy Auditor/Notary Public _____________________________________________________________
Subscribed and sworn to before me on this ________ day of ______________________, _____________
Parents’ or Guardians’ Consent
(Applicant A) Male / Female
(Applicant B) Male / Female
X
I hereby certify that I am the Parent or Guardian
I hereby certify that I am the Parent or Guardian
Signature Parent//Guardian of Applicant A
of
of
X
Signature Parent/Guardian of Applicant B
who is 17 years of age and I give my full
who is 17 years of age and I give my full
Subscribed and sworn to before me
consent to his / her marriage to
consent to his / her marriage to
on
day of
of 20
.
Deputy Auditor / Notary Public
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