Bride's Full Name (including middle name)

Groom's Full Name (including middle name)

Bride's Residential Address (address, city, state, zip code)

Please provide a non-APO, non-P.O. Box address. Nothing will be mailed to the address you provide. It is for informational purposes only, as required by the Clerk of the Court.

Bride's Birthplace (city and state)

Bride's Date of Birth (month, day, year)

Bride's Mother's Full Name (first, middle, maiden)

Bride's Mother's Current Residence (city and state)

Bride's Mother's Birthplace (city & state)

Bride's Father's Full Name (first, middle, last)

Bride's Father's Current Residence (city & state)

Bride's Father's Birthplace (city & state)

Are you a member of the U.S. Armed Forces?

Have you been previously married?

If previoulsy married, date of last divorce

If previously married, county and state of last divorce

Bride's Phone Number

Bride's E-Mail Address