700 - 0020 9 Petition for Non - Resident Minister to Perform Marriage Ceremony (0 7 /2018) Page 1 of 1 STATE OF VERMONT SUPERIOR COURT PROBATE DIVISION Unit Docket No. PETITION FOR NON - RESIDENT MINISTER TO PERFORM MARRIAGE CEREMONY Petitioner of Name) (Mailing Address) in accordance with Title 18, Section 5144 of the Vermont Statutes Annotated, requests special authorization to solemnize and perform the marriage between: of (Name) (Mailing Address) and of (Name) (Mailing Address) Now planned for in the Town of (Date of Ceremony) Petitioner hereby swears and affirms that: 1. Petitioner is a member of the clergy of the ( N ame of D enomination) in the State of ; 2. Petitioner is duly ordained or licensed, and otherwise regularly authorized thereunto by the published laws or discipline of the general conference, convention, or other authority of their faith or denomination; and 3. Petitioner has attached true and accurate copies of documentation co duly ordained or licensed member of the clergy. Title 18, Section 5144 of Vermont Statutes Annotated provides that the C the Probate judge determines that the circumstances make the ordination or license is not based upon active an d on - going ministry, and/or was obtained specifically to obtain authorization to perform the marriage in question, please identify to the C ourt the circumstances whi ch would support the required finding that this special authorization is desirable: On: Date At: Signature of Petitioner City, County and State Printed Name Signed and sworn to before me: Date Signature of Notary Public Expiration Date American LegalNet, Inc. www.FormsWorkFlow.com