SUPERIOR COURT OF THE DISTRICT OF COLUMBIA MARRIAGE BUREAU CIVIL WEDDING REQUEST INFORMATION Spouse222s Name DOB First Name M.I. Last Name Spouse222s S.S. No. // Telephone No. H/W/ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Spouse222s Name DOB First Name M.I. Last Name Spouse222s S.S. No. // Telephone No. H/W/ MARRIAGE LICENSE INFORMATION APPLICATION DATE: // LICENSE NUMBER: ISSUED DATE: // WEDDING DATE REQUESTED When do you want to be married? DATE: // TIME: : AM / PM NUMBER OF GUESTS: WILL YOU HAVE PICTURES TAKEN? YES NO HAVE YOU REQUESTED THE SERVICES OF A JUDGE OR OFFICIAL TO PERFORM YOUR WEDDING? YES NO IF YES, WHO? NAME: COURT: STATE: TELEPHONE No. WHERE WILL THE WEDDING BE PERFORMED?: ADDRESS TELEPHONE No. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ CONFIRMATION OF THE CIVIL WEDDING WEDDING APPOINTMENT MADE: // TIME: : AM / PM NAME OF THE OFFICIAL: FOR OFFICIAL USE ONLY Request Entry Made PTR Issued Appointment Made Party Notified Appointment Entry Made Disposition Entered INSTITUTIONAL IDENTIFICATION(S) SPOUSE PLACE SPOUSE PLACE DCDC# - DOB: // DCDC# - DOB:// Rev: 02/2010 American LegalNet, Inc. www.FormsWorkFlow.com