MARRIAGE LICENSE APPLICATION


INSTRUCTIONS

Please provide the information requested below to assist us in processing your marriage license. Please be prepared to present proper identification and the applicable marriage license fee, payable by Cash, Check, MasterCard or Visa. The Clerk can perform your ceremony here in the office on or after the effective date for a fee of $30.00.

IMPORTANT NOTICE: THIS IS ONLY THE FIRST STEP OF APPLYING FOR YOUR MARRIAGE LICENSE. BOTH PARTIES MUST STILL COME IN TO OUR OFFICE TO COMPLETE THE APPLICATION PROCESS AND HAVE YOUR MARRIAGE LICENSE ISSUED.

GENERAL INFORMATION - Spouse
First Name: Middle Name: Last Name:
Maiden Surname: Suffix(i.e. Jr, Sr, III, etc.):
Date of Birth: MM/DD/YYYY Birth State or Province: Birth Country:
Race: Social Security Number: (Req. by Sec. 741.04 F.S.,as revised by Chapter 97-170)
Street Address:
City: State: Zip Code:
County: Country: Phone: ()  -
Previously Married: Number of Marriages:
(including this one)
Last Marriage Ended by:
Last Marriage Ended on:  MM/DD/YYYY
GENERAL INFORMATION - Spouse
First Name: Middle Name: Last Name:
Maiden Surname: Suffix(i.e. Jr, Sr, III, etc.):
Date of Birth: MM/DD/YYYY Birth State or Province: Birth Country:
Race: Social Security Number: (Req. by Sec. 741.04 F.S.,as revised by Chapter 97-170)
Street Address:
City: State: Zip Code:
County: Country: Phone: ()  -
Previously Married: Number of Marriages:
(including this one)
Last Marriage Ended by:
Last Marriage Ended on:  MM/DD/YYYY
GENERAL INFORMATION - Both
Are you the parents of a minor child(ren) in common, born in the State of Florida?: