Petition For Dispensation Or Permission Form B Catholic Diocese Of Fargo Page 2

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PROMISES OF THE CATHOLIC PETITIONER
I, ______________________________________intend to marry ___________________________: a member of another
Church, ecclesial community, or faith, or is not practicing his/her Catholic faith. I reaffirm my faith in Jesus Christ, and
intend to continue living that faith in the Catholic Church, removing any dangers of defecting from the faith. I
acknowledge the respect I owe to the conscience of my future spouse. I promise to do all that I can to share the faith I
have received with all our children by having them baptized, reared, and educated as Catholics. My future spouse is fully
aware of my convictions. I am reasonably confident that I shall be able to live up to them.
Date:______________
Signature of the Catholic petitioner ___________________________________
The required promise and declaration have been made by the Catholic petitioner in my presence. The other party has
been informed of this requirement so that it is certain that he/she is aware of the promise and obligation on the part of
the Catholic petitioner. I believe the Catholic petitioner is sincere in his/her intentions to live up to these promises.
Witness of the above promise and signature (priest/deacon) ______________________________________
REQUEST FOR DISPENSATION FROM CANONICAL FORM
*DO NOT complete this section further unless you NEED a dispensation from canonical form
*Submit to the Tribunal at least one month in advance of Wedding Date
If there are grave difficulties in the way of observing the Catholic canonical form in a mixed marriage, the local
Ordinary of the Catholic party may dispense the Catholic from the observance of the form for a just and reasonable cause
(c. 1127, 1108). The Catholic party requests such a dispensation from the canonical form for the following:
REASON(S) FOR DISPENSATION FROM CANONICAL FORM
To permit marriage in a church of particular importance to the member of another Church or ecclesial
community
To achieve family harmony or to avoid family alienation
To obtain parental agreement to the marriage
To recognize significant relationship/friendship to minister of another Church or ecclesial community
Other (specify) ______________________________________________________________________
THE PUBLIC FORM WILL BE CELEBRATED AT:
Church:
_________________________________
Officiating Minister: ___________________________
Address:
_________________________________
Mailing Address:
___________________________
_________________________________
___________________________
When requesting Dispensation from Canonical Form, in order to aid in making a determination about the dispensation, please mail all
pre-nuptial papers (including inventory) to the Tribunal office. They will be returned to you.
PRIESTS/DEACONS PLEASE ANSWER THESE QUESTIONS
YES
NO Have both parties been instructed on the essential ends and properties of marriage?
YES
NO Are all baptismal certificates enclosed (Catholic and member of other Church or ecclesial community)?
YES
NO Was each Catholic party's baptismal certificate issued no more than six months BEFORE wedding prep?
YES
NO Does each Catholic baptismal certificate have complete notations of sacraments, particularly marriage?
YES
NO If this marriage is underage (less than 20), is a separate counselor's recommendation attached?
YES
NO If there is a Prenuptial Agreement, is this attached?
CONVALIDATION - Date & Place of attempted marriage _____________________________________________
Request relaxation of one year wait before convalidating this marriage attempt. (Provide reason in attached letter)
_________________________________ _________________________________
Priest’s Signature
Priest/Deacon’s Name (Printed)
Priest/Deacon Signature
_________________________________, _____________________________
Parish Name
City, State, Zip Code

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