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Marriage License System - Pre-Application Questionnaire
PLEASE ADVISE THE CLERK IF YOU ARE EXEMPT UNDER
FLORIDA STATUTE 119.071
* Required Fields, ** Only Required if Number of This Marriage is 2 or more.
Groom Info
Bride Info
General Info
Summary
Your correct legal name is required and must match your identification.
*First:
Middle:
*Last:
*City:
County:
*State or Country:
*Date of Birth:
/
/
*State or Country of Birth:
*Race:
American Indian
Asian
Black
Hispanic
Other
White
(mm/dd/yyyy)
*Number of this Marriage:
*Has the Groom taken a Pre-Marital Class?
Yes
No
** Date Last Marriage Ended:
/
/
(mm/dd/yyyy)
**How did the Groom's Last Marriage End?
Divorce
Death
Annul