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LeeCierkoRG

ut DA DOGGETI : CLERK OF COURT

Marriage License Application


Applicant 1: Last, First, Middle N a m e - - - - - - - - - - - - - - - - - - - - - Applicant 1: Maiden Name (if a p p l i c a b l e ) - - - - - - - - - - - - - - - - - - - Applicant 1: Date of Birth : (mm/dd/yyyy) _ _ _ _ _ _ _ _ _ Applicant 1 Age. _ _ __
Applicant 1: Residence Address, City, State, Zip: - - - - - - - - - - - - - - - - Applicant 1: County

Applicant 1 Place of Birth (State or Country) :_ _ _ __

Applicant 1: SS#

Applicant 1 Race: _ _ __

Applicant 1: Daytime Telephone#_ _ _ _ _ _ __


Applicant 1: Previously Married? __Yes __No
Applicant 1: Total Marriage(s) including this Marriage _ __
Applicant 1: Previous Marriage Ended by Divorce ___ Death ___ Annulment_ __
Date Marriage Ended _ _ _ _ _ _ __
I affirm this information is true and correct: - - - - - - - - - - - - - - - - Applicant 1 Signature
******************************************************************************************************************************

Applicant 2: Last, First, Middle N a m e - - - - - - - - - - - - - - - - - - - - Applicant 2: Maiden Name (if applicable) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __


Applicant 2: Date of Birth: (mm/dd/yyyy) _ _ _ _ _ _ Applicant 2 Age _ _ __
Applicant 2: Residence Address , City, State, Zip: - - - - - - - - - - - - - - - Applicant 2: County _ _ _ _ _ __
Applicant 2: Place of Birth (State or Country) _ _ _ _ __
Applicant 2: SS# _ _ _ _ _ _ _ __

Applicant 2 Race :_ _ __

Applicant 2: Daytime Telephone _ _ _ _ _ _ _ _ _ _ __


Applicant 2: Previously Married? __Yes __ No
Applicant 2: Total Marriage(s) including this marriage_ _ __
Applicant 2: Previous Marriage Ended by Divorce___ Death _ _ Annulment._ __
Date Marriage Ended _ _ _ _ _ _ _ _ __
I affirm this information is true and correct:

---------------Applicant 2 Signature

******************************************************************************************************************************

Please mark which address the marriage license should be mailed to after it has been recorded into the Official
Record of Lee County: _Applicant 1 _Applicant 2 _Other
(Address ; Crty , State, and Zip) - - - - - - - - - - - - - - - - - - - - - - - - - - - Notice: Once application is made most amendments to the marriage license may only be done with a
court order from Lee County

RECORDING OFFICE

PO Box 2278, Fort Myers , Fl 33902-2278 * Phone : (239) 533-5007 * Fax:(239) 485-2170

LeeCierkoRG
LI NDA DOGG ETT : CLCHK OF COU ftT

Kiosk Transaction# __________

Phone #: First Applicant _ _ _ _ _ _ __


Phone #: Second Applicant_ _ _ _ _ __

STATEMENT OF COMPLIANCE

NAME OF FIRST APPLICANT

D
2. 0
1.

Yes
Yes

0
0

(Nombre de Ia aplicante): - - - - - - - - - - -

No Are you a Florida Resident? ((. Vive o reside Usted en Ia Florida?)


No Have you completed a Premarital Preparation Course as specified in Chapter 741,

Florida Statutes? ((.Complet6 Usted un Curso de Preparaci6n Prematrimonial segun especificado en el Capitulo 741 de los
Estatutos de Ia Florida?)

3. 0

Yes

No Have you accessed and read the information contained in the Family Law Handbook

outlining the rights and responsibilities of parties to a marriage as specified in Section 741.0306, Florida
Statutes? (Lley6 Usted el Libro de Leyes Familiares que contienen los derechos y responsabilidades de los aspirantes a matrimonio
segun se especifica en Ia secci6n 7 41 .0306, de los Estatutos de Ia Florida?)

Yes
No Are you the parent of a minor child(ren) born in the State of Florida with this bride?
i_Tiene usted hijos con su novia o comprometida , que hayan nacido en el estado de Ia Florida?

4.

NAME OF SECOND APPLICANT

0
2. 0
1.

Yes
Yes

0
D

(Nombre de Ia applicante): - - - - - - - - - - -

No Are you a Florida Resident? ((. Vive o reside Usted en Ia Florida?)


No Have you completed a Premarital Preparation Course as specified in Chapter 741,

Florida Statutes? (L Complet6 Usted un Curso de Preparaci6n Prematrimonial segun especificado en el Capitulo 741 de los
Estatutos de Ia Florida?)

3.

No Have you accessed and read the information contained in the Family Law Handbook
outlining the rights and responsibilities of parties to a marriage as specified in Section 741.0306, Florida
Yes

Statutes? (Lley6 Usted el Libro de Leyes Familiares que contienen los derechos y responsabilidades de los aspirantes a matrimonio
segun se especifica en Ia secci6n 741 .0306, de los Estatutos de Ia Florida?)

4.

Yes
No Are you the parent of a minor child(ren) born in the State of Florida with this groom?
(L Tiene us ted hijos con su novio o comprometido, que hayan nacido en el estado de Ia Florida?)

By our signatures we do hereby swear and affirm that the information contained on this form is true and correct and may be relied upon
for the issuance of a marriage license. (Bajo penalidad de las !eyes aplicables, y con nuestras firm as, juramos y afirmamos que Ia
informaci6n contenida en este formula rio es cierta y correcta , Ia cual sera utilizada para emitir Ia licencia de matrimonio.)

First Applicant Signature (Firma de Ia aplicante)

Date (Fecha)

Second Applicant Signature (Firma de Ia aplicante)

Date (Fecha)

RECORDING OFFICE

PO Box 2278, Fort Myers, Fl 33902-2278 *Phone: (239) 533-5007 * Fax:(239) 485-2170

Same -Sex Marriage Ceremony Vows

(First Spouse Name) _


do you take (Second Spouse Name) to be your lawfully wedded spouse,
to live together in the Holy Estate of matrimony, to love, honor, comfort and keep him/her in
sickness and in health and forsaking all others keep you only unto him/her so long as you both
shall live?
Answers "I do"
(Second Spouse Name) do you take (First Spouse Name) to be your lawfully wedded spouse,
to live together in the Holy Estate of matrimony, to love, honor, comfort and keep him/her in
sickness and in health and forsaking all others keep you only unto him/her so long as you both
shall live?
Answers "I do"

If the couple brings rings ask the first spouse to place the ring on the second spouse's finger
and repeat these words after you.
"With this ring I thee wed, in love and truth, and with all of my worldly goods, I give you my
love.
Have the second spouse repeat the same words above after placing the ring on the first
spouse's finger.
Ask the couple to join hands and look at each other
In as much as (first spouse name) and (second spouse name) have this day consented together
in Holy Wedlock, and have given and pledged their love each to other in the presence of this
company, by virtue of authority vested in me under the laws of the State of Florida, I now
pronounce you married partners, you may kiss your spouse!

Ceremonia de Matrimonio
Solicitante 1
_ _ _ _ _ _ _ _ , recibes a
para
ser su esposa para vivir juntos en sagrado matrimonio, para
amarla(o), honrarla(o), consolarla(o), y cuidarla(o) en salud yen
enfermedad guardando fidelidad durante el tiempo que duren
sus vidas.
Solicitante 2
_ _ _ _ _ _ _ _ , recibes a
para
ser su esposa para vivir juntos en sagrado matrimonio, para
amarlo(a), honrarlo(a), consolarlo(a), y cuidarlo en salud yen
enfermedad guardando fidelidad durante el tiempo que duren
sus vidas.
Solicitante 1
Repite despues de mi: Con este anillo te case en el amory Ia verdad, y con todos mis
bienes terrenales, os doy.
Solicitante 2
Repite despues de mi: Con este anillo te case en el amory Ia verdad, y con todos mis
bienes terrenales, os doy.

En tanto
y
han consentido en sagrado matrimonio y
dando su confianza el uno al toro, en Ia presencia de esta campania. En Ia virtud me
conceden las leyes del estado de Ia Florida los declaro casados entre si , usted puede
besar!