Application For Marriage License Form
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2Application for Marriage License, Denton County, Texas
Warning: The penalty for knowingly making a false statement can be 2-10 years in prison and a fine of up to $10,000. (HSC, Sec.195.003)
The form and content of this application is prescribed by section 2.004 of the Texas Family Code.
Applicant One
Name: _________________________________________________________________________________________
First
Middle
Current Last
Maiden (if applicable)
Usual Address: __________________________________________________________________________________
Street Name and Number/Apt #
City
State
Zip
Phone #:_______________________
E-mail Address:________________________________________
Social Security #:________________________________
Date of Birth: ________________________ Age:_______
Place of Birth:____________________________________________________________________________
City
County
State
I have not been divorced within the last 30 days.
True
False______
______
I am not presently married and the other applicant is not presently married.
True______
False______
I am not presently delinquent in the payment of court-ordered child support.
True_____False______
The other applicant is not related to me as: an ancestor or descendant by blood or adoption; a brother or sister, of the whole or
by half blood or by adoption; a parent’s brother or sister of the whole or half blood or by adoption; a son or daughter of a brother
or sister of the whole or half blood or by adoption; a current or former stepchild or stepparent; a son or daughter of a parent’s
brother or sister, of the whole or half blood or by adoption.
True____ False____
I wish to make a voluntary contribution of $5.00 to promote healthy early childhood by supporting the Texas Home
Visitation Program administered by the Office of Early Childhood Coordination of the Health and Human Services.
_______________________________________________________________________________________
Applicant Two
Name: _________________________________________________________________________________________
First
Middle
Current Last
Maiden (if applicable)
Usual Address: __________________________________________________________________________________
Street Name and Number/Apt #
City
State
Zip
Phone #:_______________________
E-mail Address: ________________________________________
Social Security #:________________________________
Date of Birth: ________________________ Age: _______
Place of Birth:____________________________________________________________________________
City
County
State
I have not been divorced within the last 30 days.
True
False______
______
I am not presently married and the other applicant is not presently married.
True______
False
______
I am not presently delinquent in the payment of court-ordered child support.
True_____False
______
The other applicant is not related to me as: an ancestor or descendant by blood or adoption; a brother or sister, of the whole or
by half blood or by adoption; a parent’s brother or sister of the whole or half blood or by adoption; a son or daughter of a brother
or sister of the whole or half blood or by adoption; a current or former stepchild or stepparent; a son or daughter of a parent’s
brother or sister, of the whole or half blood or by adoption.
True____ False____
I wish to make a voluntary contribution of $5.00 to promote healthy early childhood by supporting the Texas Home
Visitation Program administered by the Office of Early Childhood Coordination of the Health and Human Services.
: _________________________
________________________
Date of Marriage
County of Marriage:
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