CONFIDENTIAL MARRIAGE LICENSE APPLICATION
Los Angeles / Valleys (310) 667-6060....South Bay / Long Beach (562) 799-1206....Orange County (714) 453-9971
Please fill this form out COMPLETELY and click SUBMIT at the bottom of the page
All fields must be filled in. If not applicable put NA.
Party 1 PERSONAL DATA
Your Names
Phone
Email
Your Full Address where you live together
You are stating that you live together at this location
County
Mailing Address (if different)
First Name
Middle Name
Last Name
Birth Last Name (if different)
Date of Birth
STATE of Birth (or Country if not US)
Number of Previous Marriages
Last Marriage ended in (select one) Divorce, Annulment, Death, NA)
DATE Last Marriage Ended
Fathers STATE of Birth
(or Country if not USA
Mothers FULL MAIDEN name
Fathers FULL Name
Mothers STATE of Birth
(or Country if not USA)
Your Names MUST
match your ID exactly
First Name
Middle Name
Current Last Name
Birth Last Name (if different)
Date of Birth
STATE of Birth (or Country if not US)
Number of Previous Marriages
Last Marriage ended in (select one) Divorce, Annulment, Death, NA)
DATE Last Marriage Ended
Fathers STATE of Birth
(or Country if not USA
Mothers FULL MAIDEN name
Fathers FULL Name
Mothers STATE of Birth
(or Country if not USA)
Party 2 PERSONAL DATA
Your Name MUST
match your ID exactly
Where and when do you want the license issued? Did you need a ceremony too? Additional Info I should know?
Thank You for submitting your information. I will contact you shortly to discuss your license.
Before you click to submit, please review all the information for accuracy
This is what will appear on your license.
If the information is incorrect or mispelled or does not match your ID
your license may have to be revised or redone for an additional fee
My County Authorization card
to Issue Marriage Licenses
My Ordaination Certificate
to Perform Weddings
Dont be fooled!!

In order to Issue Marriage Licenses
One MUST be Authorized by the County
As I am

To Perform Legal Marriages
One MUST either be a Judge
or Ordained as a Minister
As I am
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