| .DATE TRANSCRIBED | BOOK PAGE | DOCUMENT # | ||
|
NAME
OF GROOM -FIRST and MIDDLE NAMES
. |
LAST NAME | CLASS | DATE OF BIRTH | |
| AGE
. |
NUMBER OF THIS MARRIAGE | DATE LAST MARRIAGE ENDED | LAST MARRIAGE ENDED BY | BIRTHPLACE |
| RESIDENCE OF
GROOM -STREET ADDRESS
|
CITY OR TOWN | COUNTY | ||
| PRESENT OR LAST
OCCUPATION
. |
KIND OF INDUSTRY OR BUSINESS | HIGHEST SCHOOL GRADE COMPLETED | ||
| NAME OF FATHER
OF GROOM
. |
BIRTHPLACE OF FATHER | MAIDEN NAME OF MOTHER | BIRTHPLACE | |
| NAME OF BRIDE
-FIRST and MIDDLE NAMES
. |
LAST NAME | CLASS | DATE OF BIRTH | |
| AGE
. |
NUMBER OF THIS MARRIAGE | DATE LAST MARRIAGE ENDED | LAST MARRIAGE ENDED BY | BIRTHPLACE |
| RESIDENCE OF
BRIDE -STREET ADDRESS
|
CITY OR TOWN | COUNTY | ||
| PRESENT OR LAST
OCCUPATION
. |
KIND OF INDUSTRY OR BUSINESS | HIGHEST SCHOOL GRADE | MAIDEN NAME | |
| NAME OF FATHER
OF BRIDE
. |
BIRTHPLACE OF FATHER | MAIDEN NAME OF MOTHER | BIRTHPLACE | |
| (AFFIDAVIT OF BRIDE AND GROOM ) | ||||
| BRIDE'S
SIGNATURE
. |
GROOM'S SIGNATURE | |||
|
|
||||
| SUBSCRIBED
AND SWORN TO BEFORE ME |
DATE LICENSE
ISSUED
. |
LICENSE NUMBER | COUNTY CLERK | |
| EXPIRATION
DATE
. |
COUNTY OF ISSUANCE OF LICENSE | DEPUTY | ||
| SIGNATURE OF
WITNESS
. |
ADDRESS OF WITNESS - STREET | ADDRESS OF WITNESS - CITY AND STATE | ||
| SIGNATURE OF
WITNESS
|
ADDRESS OF WITNESS - STREET | ADDRESS OF WITNESS - CITY AND STATE | ||
|
|
SIGNATURE OF PERSON PERFORMING CEREMONY AND OFFICIAL TITLE | |||
| DATE OF MARRIAGE
|
NAME OF PERSON PERFORMING CEREMONY | . | ||
| PLACE OF MARRIAGE
. |
ADDRESS OF PERSON PERFORMING CEREMONY - CITY AND STATE | |||
| DATE
ACCEPTED FOR REGISTRATION
. |
LOCAL REGISTRAR - SIGNATURE | |||
The gray areas are matter of small importance to researchers and can be omitted from your transcript.
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