Wedding License Application

1a. Name Of Husband - First (given) :

1b. Middle:

1c. Last:

2. Date Of Birth - Month/Day/Year

3. State Of Birth

4. Number of Previous Marriages

5a. Last Marriage Ended By (Death/Dissolution/Annulment)

5b. Date of Above

6a. Usual Occupation

6b. Usual Kind Of Business or Industry

7. Education - Years Completed

8a. Full Name Of Father

8b. Father's State Of Birth

9a. Full Maiden Name Of Mother

9b. Mother's State Of Birth

10a. Name Of Wife - First (given):

10b. Middle:

10c. Current Last (family):

10d. Maiden Last (family) If Different From 10c:

11. Date Of Birth - Month/Day/Year

12. State Of Birth

13. Number of Previous Marriages

14a. Last Marriage Ended By (Death/Dissolution/Annulment)

14b. Date of Above

15a. Usual Occupation

15b. Usual Kind Of Business or Industry

16. Education - Years Completed

17a. Full Name Of Father

17b. Father's State Of Birth

18a. Full Maiden Name Of Mother

18b. Mother's State Of Birth

19a. Residence - Street and Number

19b. City

19c. Zip Code

19d. County (Outside California, Enter State)

20a. Mailing Address (If Different)

20b. City

20c. Zip Code

20d. County (Outside California, Enter State)

(The following will not be part of your Wedding License)

Wedding Date:

E-mail Address:

Phone:

Additional Comments for The Minister: