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2. SPOUSE ONE
6. First Name*
7. Middle Name
8. Current Last Name*
10. Birth Name (if different)
12. Middle Name (After Marriage)

    A response is only required if you intend to change your middle name after marriage.

13. Last Name (After Marriage)

    A response is only required if you intend to change your last name after marriage.

    
    

15. Address*
17. City*
18. State*
19. Zip Code*
21. Town*
22. County*
24. Phone Number*
25. Email Address*
27. Date of Birth*
28. Age*
29. Place of Birth (City & State)*
31. Sex*

    1. Male
    2. Female
    3. Non-binary
32. Active Duty? *

    1. Yes
    2. No
33. Usual Occupation/Job Title*
35. Have you ever been married before?*

    1. Yes
    2. No
36. # of Previous Marriages
    -- Select One --012345
37. Previous Marriage Ended By:*

    1. Divorce
    2. Annulment
    3. Death
    4. Not Applicable
39. Father or Parent Name*
40. Country of Birth*
42. Mother or Parent Name*
43. Country of Birth*
47. SPOUSE TWO
49. First Name*
50. Middle Name
51. Current Last Name*
53. Birth Name (if different)
55. Middle Name (After Marriage)

    A response is only required if you intend to change your middle name after marriage.

    
    

56. Last Name (After Marriage)

    A response is only required if you intend to change your last name after marriage.

58. Address*
60. City*
61. State*
62. Zip Code*
64. Town*
65. County*
67. Phone Number*
68. Email Address*
70. Date of Birth*
71. Age*
72. Place of Birth (City & State)*
74. Sex*

    1. Male
    2. Female
    3. Non-binary
75. Active Duty? *

    1. Yes
    2. No
76. Usual Occupation/Job Title*
78. Have you ever been married before?*

    1. Yes
    2. No
79. # of Previous Marriages
    -- Select One --012345
80. Previous Marriage Ended By:*

    1. Divorce
    2. Annulment
    3. Death
    4. Not Applicable
82. Father or Parent Name*
83. Country of Birth*
85. Mother or Parent Name*
86. Country of Birth*
Leave This Blank:


88. 1. Receive an email copy of this form.
89. Email address

    This field is not part of the form submission.

90. Submit

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