Public Marriage License Application Form - State Of California - County Of Marin
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APPLICATION FOR
LICENSE AND CERTIFICATE OF MARRIAGE
NO: ______
STATE OF CALIFORNIA - COUNTY OF MARIN
ONE APPLICATION PER COUPLE AND BOTH MUST APPEAR IN PERSON
$85.00 FEE: CASH OR CHECK, PAYABLE TO “MARIN COUNTY CLERK”
A public marriage license is public information. If confidentiality is an issue, please see the application for a confidential license.
You will be asked to swear (or affirm) that the information you have provided is true, that you are currently unmarried, and that there
is no legal objection to the marriage.
ADDITIONAL INFORMATION MAY BE FOUND ON THE BACK OF THIS APPLICATION
ST
1A. 1
PERSON FIRST NAME :
1B. MIDDLE :(no initials)
1C. CURRENT LAST NAME(S):
1D. LAST NAME AT BIRTH:
PERSONAL
(IF DIFFERENT THAN 1C)
DATA: (required)
2. DATE OF BIRTH:
3. STATE or COUNTRY OF BIRTH:
4. # OF PREVIOUS
5A. LAST MARRIAGE ENDED BY:
5B. DATE MARRIAGE ENDED:
MARRIAGES/SRDP:
( MM
DD
YYYY)
Neither
__________/__________/________
_________/_________/__________
TERM. OF STATE REG.DOM.PARTNRS
DEATH
DIVORCE
ANNULMENT
6. ADDRESS:
7. CITY:
8. STATE/COUNTRY:
9. ZIP CODE:
Bride
10A. FATHER/PARENT’S FULL NAME(S):
10B.STATE OF BIRTH:
11A. MOTHER/PARENT’S FULL NAME(S) AT HER BIRTH:
Groom
11B. STATE OF BIRTH:
(COUNTRY IF NOT US)
(COUNTRY IF NOT US)
ND
12A. 2
PERSON FIRST NAME :
12B. MIDDLE :(no
12C. CURRENT LAST NAME (S):
12D. LAST NAME AT BIRTH:
PERSONAL
initials)
(IF DIFFERENT THAN 1C)
DATA: (required)
13. DATE OF BIRTH:
14. STATE or COUNTRY OF BIRTH:
15. # OF PREVIOUS
16A. LAST MARRIAGE ENDED BY:
16B. DATE MARRIAGE ENDED:
( MM
DD
YYYY)
MARRIAGES/SRDP:
__________/__________/________
_________/_________/__________
TERM. OF STATE REG.DOM.PARTNRS
Neither
DEATH
DIVORCE
ANNULMENT
17. ADDRESS:
18. CITY:
19. STATE/COUNTRY:
20. ZIP CODE:
Bride
21A. FATHER/PARENT’S FULL NAME(S):
21B. STATE OF BIRTH:
22A. MOTHER/PARENT’S FULL NAME(S) AT HER BIRTH:
22B. STATE OF BIRTH:
Groom
(COUNTRY IF NOT US)
(COUNTRY IF NOT US)
I have read and understand both front and back of
PHONE NUMBER: ______________________
this application,:
2 initials required
First Person ___________Second person___________
NAME
CHANGE:
ST
ND
1
PERSON: Middle ________________ Last _________________ 2
PERSON: Middle ___________________ Last_______________________
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