Sample Application

 

(Please Type)                                                                  No._________

                         APPLICATION FOR MARRIAGE LICENSE

 We____Dorie Sweetness________________       of___NY NY      _________________
                                                                             (Permanent Residence)
and___Andy Amazing___________________       of___NY NY_______________________
                                                  
(Permanent Residence)

 do hereby apply for and request that a marriage license be granted us to enter

 into marriage in ______St John______, Virgin Islands, and we do further respectfully represent that the following statements are true and correct:

                      MALE                                FEMALE

Full Name _____Andy Nathan Amazing______      ____ Dorie Sweetness_    ___

SS No. _______870-59-6592        _______      ______174-87-6269____________

Date of Birth _July 9 1948  ____________      _____August 8 1959____________

Place of Birth ___Hartford  Conn.  ______      ____Raleigh NC________________

Nationality ____American_________________      ____American___________________

Usual Residence __New York NY____________      _____New York NY__________________

Parents:             Hank James Amazing          Charles Irving Sweetness

      Present Name __Mary Louise Amazing      ___Betty Lou Sweetness____________

      Maiden Name ___Mary Louise Smith__      ____Betty Lou Jones_______________

                     NY NY (fathers)              Raleigh NC

      Place of Birth Stamford Conn._(mothers)     ____Cary NC_______________________

Previous Marital Status __single________      ____divorced_____________________

Related to other Applicant? __no_________      _______no____________________

In what degree? _____n/a__________________      ______n/a   ____________________

Signature ____sign your name_____________      _______sign your name___________

 _       
|_|PLEASE CHECK THIS BOX IF YOU ARE REQUESTING EXEMPTION TO THE EIGHT DAY POSTING REQUIREMENT EXPLAINED IN THE ATTACHED MARRIAGE INFORMATION.
   
WE ARE REQUESTING EXEMTION BECAUSE OF THE FOLLOWING CIRCUMSTANCES:
_____________________________________________________________________________
_____________________________________________________________________________

THE COURT, HAVING REVIEWED THIS APPLICATION DETERMINES THAT SPECIAL CIRCUMSTANCES EXIST TO ISSUE A LICENSE WITHOUT THE POSTING REQUIRED BY TITLE 16 SECTION 38 OF THE VIRGIN ISLANDS CODE.

______________________________________________

______________________________________________

Subscribed and sworn to by each of the above parties    (They do this at the court on St Thomas)

this _________ day of _________,  ____

License issued this __________ day of __________,  ____

         Filed this __________ day of __________,  ____

 

                                                Clerk of the Territorial Court

 

                                                By ________________________

                                                         Deputy Clerk