Notarized Marriage License Information Form - Spouse Absent

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Ricky Hatch, CPA
NOTARIZED MARRIAGE
Weber County Clerk/Auditor
LICENSE INFORMATION
2380 Washington Blvd., Suite 320
Ogden, UT 84401-1456
FORM – SPOUSE ABSENT
Phone: (801) 399-8400
*PLEASE READ CAREFULLY*
These instructions must be followed exactly in order to obtain a marriage license where one spouse cannot be
present at the time of application. This form is for the absent spouse only.
1. All personal data, except signature, must be completed in ink before the document is notarized.
2. This form must be signed in the presence of a notary, who will verify the identity of the person signing.
3. Note that the spouse who will appear in person will complete a separate marriage license application.
Choose Your Preferred Title:  Spouse
 Bride
 Groom
ABSENT SPOUSE:
Legal Name Today: ________________________________________________________________________________
First
Middle
Maiden
Last
Address Today: ___________________________________________________________________________________
Number & Street
City
County
State
ZIP
State of Birth: _________________________________ Date of Birth: _________________________
Age: _______
If not USA, name Country
Month / Day / Year
Social Security Number: _________-________-___________
Race: _____________________
Gender: _________
Number of This Marriage: _______
How Did Last Marriage End? ________________
Date Ended: _______________
Death/Divorce/Annulled
Month/Year
Parent 1: ________________________________________________ Gender: ______ State of Birth:_______________
Legal Name
First
Maiden
Last
If not USA, name Country
Parent 2: ________________________________________________ Gender: ______ State of Birth:_______________
Legal Name
First
Maiden
Last
If not USA, name Country
I INTEND TO MARRY:
Legal Name: _____________________________________________________________
First
Middle
Maiden
Last
I, desiring to procure a license to marry, do solemnly swear that I am unmarried and may lawfully
contract and be joined in marriage; that I am not related to my intended spouse within, but not
including, the fifth degree of consanguinity (generally means first cousins) and that the above
information is true, according to my best knowledge and belief.
SIGNATURE:______________________________________________ PHONE: _______________________
**MUST BE SIGNED IN THE PRESENCE OF THE NOTARY**
(Include a phone # in case we have questions.)
In the County of __________________, State of ____________, on this _____ of __________, _______, before me
County
State
Day
Month
Year
_______________________________, a notary public, personally appeared____________________________________,
Notary Public Name
Name of Document Signer
proved on the basis of satisfactory evidence to be the person whose
name is subscribed to this instrument, and acknowledged (he/she)
executed the same. Witness my hand and official seal.
______________________________________________
Notary Signature and Seal
Marriage License Application - Notarized if One Party Cannot Appear in Person, version 2.1. Rev. 10/15

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