1. Full name of Groom.
2. Place of Residence.
3. Occupation.
4. Age next Birthday in years, Color, Race.
5. Place of Birth.
6. Father's name.
7. Mother's maiden name.
8. Number of Groom's Marriage.
9. Full name of Bride; Maiden name, if a Widow.
10. Place of Residence.
11. Age next Birthday in years, Color, Race.
12. Place of Birth.
13. Father's Name.
14. Mother's Name.
15. Number of Bride's Marriage.
16. Married at; day; year.
17. Witnesses to Marriage.
** Witnesses that info is correct.
** Signatures of Groom and Bride.
** Who preformed the Wedding.
*NOTE: If you ask for a copy of the jacket, you'll get filing date, Registered, and Marriage
Register information.
Example of Application
Example of License


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