{[PNAME]}

Intended date of the event*

In which Municipality? *

{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}

Provide details of where and when the event will be held (in the State of New Jersey)

Event

What is this application for? *

Applicant A
Applicant B
Ceremony

Applicants MUST provide their social security numbers (N.J.S. 37:1-17). Social Security Numbers shall be kept confidential and may only be released for child support purposes and this document shall not be considered a public record pursuant to P.L. 1963, C.73 (C.47:1A-1 et seq.) Giving false information constitues perjury.

(For Remarriage to the same spouse, or Reaffirmation of Civil Union to the same partner ONLY)

Email *

Place

No. of times ever in a Civil Union

No. of times ever Married

Name of Most Recent Spouse

Parent's Full Name at Birth *

Current Name (if different)

Name of Most Recent Civil Union Partner

County *

State *

Name on Birth Certificate (First, Middle, Last) *

Date of Status Change

Municipality of Residence *

Domestic Status (at this time) *

Place of Birth *

Date of Birth *

If "YES," how?

Type of Ceremony

Social Security Number

Street Address *

Phone *

Place of Birth *

Parent's Full Name at Birth *

Declaration of Applicant A

Gender *

Place

Date

Place of Birth *

Are you related to Applicant B? *

ZIP *

Place of Birth *

ZIP *

Name of Most Recent Spouse

Current Name (if different)

Date of Birth *

Parent's Full Name at Birth *

Name on Birth Certificate (First, Middle, Last) *

County *

Email *

Type of Ceremony

If "YES," how?

Name of Most Recent Civil Union Partner

Place of Birth *

No. of times ever in a Civil Union

Street Address *

Are you related to Applicant A? *

Place of Birth *

Place

Date of Status Change

Declaration of Applicant B

(For Remarriage to the same spouse, or Reaffirmation of Civil Union to the same partner ONLY)

Place

No. of times ever Married

Domestic Status (at this time) *

State *

Parent's Full Name at Birth *

Phone *

Gender *

Municipality of Residence *

Social Security Number

Date

Phone # *

State *

Provide details of the person that will be officiating the ceremony

Name (First, Middle, Last)

Mailing Address

Title (Priest, Minister, Rabbi, etc.)

Provide a mailing address and phone number where either applicant can be reached after the ceremony

Witness

City

ZIP *

State *

State

Name (First, Middle, Last) *

Mailing Address *

Next Steps

Correspondence

City *

ZIP

Officiant

Appointments are scheduled between 9:00-11:30 and 2:00-3:30 during the week. Please list your preferred appointment date:

ZIP *

City *

The applicants named in this application must appear before the Registrar TOGETHER, unless previously authorized by the Registrar, or in the event of an emergency.

Note that this application CANNOT be mailed to the Registrar's Office.

When presenting yourselves to the Registrar you must bring the following items with you:

A copy of the prepared application that will be emailed to you after you "Request Appointment" below.
Proof of identity, e.g. Driver's license, passport or state/federal I.D.
Proof of residency, only if your identification is not your valid Driver's License and you live in {[CITY]}, e.g. Bank Statement, Utility Bill, Pay Stub within last ninety (90) days.
Your Social Security Number (will be kept confidential)
A witness, eighteen (18) years of age or older (must speak/understand English)
Application Fee of $28.00, which will be payable at the time of your appointment.
If either applicant is divorced or widowed (Date & Place of Divorce/Widowed )

The witness must know BOTH Applicants, and must be aged eighteen (18) years or older. This witness must present themselves WITH the Applicants to the Registrar’s Office to sign the Oath of Application and Identifying Witness.