STATE OF CONNECTICUT MARRIAGE WAIVER PC-980 REV. 7/12 RECORDED: COURT OF PROBATE THIS IS NOT A MARRIAGE LICENSE. RETURN TO REGISTRAR OF VITAL STATISTICS. TO: COURT OF PROBATE, DISTRICT NO. PETITIONER [Name, address, zip code and telephone number.] DATE OF BIRTH PETITIONER [Name, address, zip code and telephone number.] DATE OF BIRTH The petitioner hereby requests the following: Consent to the issuance of a marriage license to a person under 16 years of age. Consent to the issuance of a marriage license for those persons under the age of 18 where no parent or guardian of the minor is a resident of the United States. C.G.S. §46b-30. .................................................................... Petitioner: .................................................................... Petitioner: AT A COURT OF PROBATE HELD AT The foregoing application having been presented to this Court, the Court finds that for cause shown, as required by law, the requirements of the appropriate statute have been met, and the petition is granted as follows: The Court consents to the issuance of a marriage license to a person under 16 years of age. The Court consents to the issuance of a marriage license for those persons under the age of 18 where no parent or guardian of the minor is a resident of the United States. C.G.S. §46b-30. Dated at: ,Connecticut, on [Month, Day, Year] .......................................................................... Judge THIS DOCUMENT RECEIVED FOR RECORD ON REGISTRAR BY MARRIAGE WAIVER PC-980 American LegalNet, Inc. www.FormsWorkFlow.com