Intended date of the Event
{[PNAME]}
Clerk of
Are You Member of?
If so, mention (State/Country)
Provide details about the clerk with whom the marriage will take place (in the Commonwealth of Massachusetts)
If so, Dissolved?
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[PPHONE]}
{[AWEBSITE]}
If so, Dissolved?
Are You Member of?
Event
If so, mention (State/Country)
  • Applicant A
  • Applicant B
  • Ceremony
Email
City/Town (Place of Birth)
City/Town
Have you been married before?
Are you related to Applicant B?
Father's Last Name at their Date of Birth
Residency Street Address
Phone #
State
ZIP
# of times ever Married
Father's Last Name at PARTY A Date of Birth
Declaration of Applicant A
Father's First Name
Current Name (First, Middle, Last)
Is there any reason why you would be prohibited from marrying in Massachusetts due the laws of another state or jurisdiction?
Country
State
Date of Birth
Status of Last Marriage?
If "Yes," how?
Full Name to be used after marriage
is SSN issued?
Mother's Last Name at their Date of Birth
Mother's First Name
Country
Applicants MUST provide their social security numbers. 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. Giving false information constitutes perjury.
Age
Occupation
Mother's Last Name at PARTY A Date of Birth
If not issued, indicate the reason
If "Yes," how?
Residency Street Address
Occupation
# of times ever Married
Father's Last Name at PARTY B Date of Birth
Country
State
Phone #
City/Town
Full Name to be used after marriage
Current Name (First, Middle, Last)
Date of Birth
Declaration of Applicant B
If not indicate state the reason
Status of Last Marriage?
Mother's Last Name at PARTY B Date of Birth
Father's First Name
Have you been married before?
State
Mother's First Name
Country
Applicants MUST provide their social security numbers. 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. Giving false information constitutes perjury.
Age
Email
Mother's Last Name at their Date of Birth
Father's Last Name at their Date of Birth
Are you related to Applicant A?
Is there any reason why you would be prohibited from marrying in Massachusetts due the laws of another state or jurisdiction?
ZIP
is SSN issued?
City/Town (Place of Birth)
Provide a mailing address and phone number where either applicant can be reached after the ceremony
I have reviewed a list of impediments to marriage and hereby state that there is an absence of any legal impediment to this marriage and do hereby depose and say that all of the statement as set forth in the above notice whereof I could have knowledge are true and are made under the penalties of perjury (M.G.L c.4 §6, Rule 6 General Laws).
Amount Due:
Marriage License Fee
License Fee $35
Credit Card Convenience Fee (if applicable) $1.36
Mailing Address
Attachments
Certification
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:

  1. A copy of the prepared application that will be emailed to you after you "Submit" below.
  2. Your Social Security Number (will be kept confidential)
  3. Application Fee of $35.00 in case of not paying while submitting the application
City
Next Steps
Payment Method
Correspondence
State
ZIP
Fees
Phone #