Petition Requesting A Dispensation From Canonical Form
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1
2ARCHDIOCESE OF ANCHORAGE
PETITION REQUESTING A DISPENSATION FROM CANONICAL FORM
NAME:_________________________
P.N.____________
GRANTED__________
The bride/groom, _________________________ a Catholic of ____________________ parish
(please circle)
wishes to enter into marriage with _________________________, a baptized/unbaptized person
(please circle)
of the following denomination _________________________ on _________________________ at
____________________________ in the city of ____________________________.
The officiant will be: _________________________ a minister from ________________________.
The grave cause for which we are requesting this exceptional dispensation is:
_______________________________________________________________________________
_______________________________________________________________________________
____________________________________________________________________________.
(A request for permission/dispensation for marriage form should be included if needed)
x______________________________
____________________
Priest/Deacon/Parish Director
Date
Parish Seal
____________________________________________________________________________
Parish
Address
City
State
Zip Code
I hereby grant this request for DISPENSATION FROM FORM
by virtue of canons 1078,1 and 1118 of the 1983 Code of Canon Law,
Given at Anchorage, Alaska on ____________________
Diocese Seal
__________________________________
Archbishop, Vicar General or Judicial Vicar
(Notation should be made that this dispensation has in fact been used and that the marriage has
been properly recorded at the appropriate parish.)
The above-cited marriage took place at _______________________in _____________, Alaska on
____________________The pertinent facts have been dully inscribed in the Sacramental Records
of this Parish.
Priest:
_________________________
Parish:
________________________
Address:
_________________________
Date:
________
(Dispensation from Form 07/09)
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