Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Lawyer's Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent For Clerk's Use Only I am the Legal Guardian of the adult whose marriage license needs correction SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the matter of Case Number: CV Person petitioning to correct marriage license APPLICATION TO CORRECT MARRIAGE LICENSE issued in Maricopa County Other Spouse UNDER PENALTY OF PERJURY 1. INFORMATION ABOUT THE PERSONS whose marriage license needs correction: FULL CORRECT NAME OF FULL CORRECT NAME OF Bride Bride Groom Groom Spouse: Spouse: 2. INFORMATION ON THE MARRIAGE LICENSE A. Marriage License Number: B. The marriage license contains INCORRECT information for the Spouse: Bride's Bride's Groom's Groom's Spouse's Name appears wrongly as: Spouse's Age appears wrongly as: Bride Groom Following is the CORRECT information about the Bride Groom Spouse: I ask that the marriage license be ordered changed as indicated below: Bride's Bride's Groom's Groom's Spouse's Name* should appear as listed in "1", above. Spouse's Age should appear as Groom Spouse as it appears on * to correct the an error in the name of the Bride the Marriage License ­ not to change identity. © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 1 of 2 CVAML11f-042516 American LegalNet, Inc. www.FormsWorkFlow.com Case No. C. The marriage license contains INCORRECT information for the Spouse: Bride's Bride's Groom's Groom's Spouse's Name* appears wrongly as: Spouse's Age appears wrongly as: Bride Groom Following is the CORRECT information about the Bride Groom Spouse: I ask that the marriage license be ordered changed as indicated below: Bride's Bride's Groom's Groom's Spouse's Spouse's Name* should appear as appears in "1", above. Age should appear as Groom Spouse as it appears on * to correct the an error in the name of the D. Bride the Marriage License ­ not to change identity. The marriage license contains INCORRECT information on the date of marriage: Date of Marriage appears wrongly as: Following is the CORRECT information about the date of marriage. I ask that the marriage license be ordered changed as indicated below: Date of Marriage should appear as: REQUEST TO THE COURT: I request the Clerk of Superior Court be ordered to replace the incorrect information on the subject marriage license with the correct information as indicated above. PLEASE NOTE: The correction will NOT replace your existing marriage license, but is an amendment to it. OATH OR AFFIRMATION OF APPLICANT We/I affirm under penalty of perjury the information provided on this document is true and correct. Date: Petitioner's Signature Petitioner's Printed Name STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) . by (Non-Petitioner) Spouse's Signature (Non-Petitioner) Spouse's Printed Name (notary seal) © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 2 of 2 Deputy Clerk or Notary Public CVAML11f-042516 American LegalNet, Inc. www.FormsWorkFlow.com