Marriage Kiosk
Spouse 1/Groom
Party 1 First Name
(Nombre Primero)
Party 1 Middle Name
(Segundo)
Party 1 Last Name
(Appelido)
Party 1 Suffix
(Sufijo)
Party 1 Maiden/Given Name
(Appelido de soltera)
Party 1 Race
(Race)
Party 1 SSN
(Seguro Social)
--Select One--
AFRICAN AMERICAN
ALASKAN NATIVE
AMERICAN INDIAN
ASIAN
CAUCASIAN
HISPANIC
MIDDLE EASTERN
OTHER
PACIFIC ISLANDER
Party 1 Street Address
(Direccion)
Party 1 City
(Ciudad)
Party 1 State
(Estado o Pais)
Party 1 Zip Code
(Codigo Postal)
Party 1 County
(Condado)
Party 1 Phone
(Teléfono)
Party 1 Date of Birth
(Fecha de Nacimiento - MM/dd/yyyy)
Party 1 Birth State
(Nacimiento Estado o Pais)
Party 1 Ever Married
(Anteriorment se casó?)
Party 1 Number of this Marriage
(Número de este matrimonio)
Party 1 Last Marriage Ended Date
(Fecha de matrimonio anterior - MM/dd/yyyy)
Party 1 Marriage Ended
(Ultimo Martrimonio Termino Por)
--Select One--
Annulment
Death
Divorce
Spouse 2/Bride
Party 2 First Name
(Nombre Primero)
Party 2 Middle Name
(Segundo)
Party 2 Last Name
(Appelido)
Party 2 Suffix
(Sufijo)
Party 2 Maiden / Given Name
(Appelido de soltera)
Party 2 Race
(Race)
Party 2 SSN
(Seguro Social)
--Select One--
AFRICAN AMERICAN
ALASKAN NATIVE
AMERICAN INDIAN
ASIAN
CAUCASIAN
HISPANIC
MIDDLE EASTERN
OTHER
PACIFIC ISLANDER
Party 2 Street Address
(Direccion)
Party 2 City
(Ciudad)
Party 2 State
(Estado)
Party 2 Zip Code
(Codigo Postal)
Party 2 County
(Condado)
Party 2 Phone
(Teléfono)
Party 2 Date oF Birth
(Fecha de Nacimiento - MM/dd/yyyy)
Party 2 Birth State
(Nacimiento Estado o Pais)
Party 2 Ever Married
(Anteriorment se casó?)
Party 2 Number of this Marriage
(Número de este matrimonio)
Party 2 Last Marriage Ended Date
(Fecha de matrimonio anterior - MM/dd/yyyy)
Party 2 Marriage Ended
(Ultimo Martrimonio Termino Por)
--Select One--
Annulment
Death
Divorce
2025 - Marriage Kiosk
