ATTENTION YOU MUST PERSONALLY CONTACT THE BOWLING GREEN SENTINEL TRIBUNE TO OMIT YOUR NAME FROM PUBLICATION. HOWEVER, THE TOLEDO BLADE PRINTS ALL NAMES. Please verify the accuracy of all information. This application cannot be changed once it is submitted. If you have any questions, please ask. Date of Application: __________________________ 1. Marriage License: ________________________ Groom's Name: _________________________________________________________________________________ Current Legal First & Last Name (Middle Name or Initial Optional) 2. Residence: ____________________________________________________________________________________ Street 3. Date of Birth: 4. Home Phone: ( / City /_ _ __ _ )________________ County Age: _________ State Zip Code Social Security #: ________________________ Birth Place: ________________________________________________ City 5. Address after Marriage: __________________________________________________________________________ Street 6. Mother's Maiden Name: _________________________________ Zip Code Is Your Father Deceased? Yes____ No____ Is Your Mother Deceased? Yes____ No____ First Parent's Address(es): ____________________________________________________________________________ Street 9. State First Last 8. City Father's Name: _______________________________________ Last 7. State City Your Occupation: ____________________________________ State Work Phone: ( Zip Code )________________ 10. Your Employer: _________________________________________________________________________________ 11. Have you been previously married? Yes_____ No_____ How many times?____________ 12. Name of First Spouse: ___________________________________________________ Deceased ( ) Divorced ( ) First and Last Name at Time of Marriage Names and Ages of Minor Children by this Marriage: ____________________________________________________ ______________________________________________________________________________________________ 13. Name of Second Spouse: _________________________________________________ Deceased ( ) Divorced ( ) First and Last Name at Time of Marriage Names and Ages of Minor Children by this Marriage: ____________________________________________________ ______________________________________________________________________________________________ 14. Name of Third Spouse: ___________________________________________________ Deceased ( ) Divorced ( ) First and Last Name at Time of Marriage Names and Ages of Minor Children by this Marriage: ____________________________________________________ ______________________________________________________________________________________________ 15. Name and Title of Person to Perform the Ceremony: ____________________________________________________ Date set for the Ceremony: _______________________________ Crensch$\forms \marriageapplicationgroom.doc 7/26/01 American LegalNet, Inc. www.USCourtForms.com