Your Town, USA 00000
www.yourtown.gov
Your Town
(555) 555-5555
Application for License
Giving false information constitutes perjury
123 Main Ave
  • Declaration of Applicant A
  • Declaration of Applicant B
  • To be completed by either Applicant
  • Prepare Application
Social Security Number of Applicant A
Email
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.)
Municipality
Name of Most Recent Spouse (if any)
Are you related to Applicant B?
Current Name (if different)
APPLICANTS MUST PROVIDE THEIR SOCIAL SECURITY NUMBERS (N.J.S. 37:1-17)
Sex
Street Address
Place
Telephone #
State
(For Remarriage to the same spouse, or Reaffirmation of Civil Union to the same partner ONLY)
Ceremony Type
Date
Domestic Status (at this time)
Zip
Date
Parent's Full Name at Birth
County
Contact Information
Birthplace
Date of Birth
If "Yes," how?
Birthplace
Name (First, Middle, Last)
Number of times ever in a Civil Union (if applicable)
Name of Most Recent Civil Union Partner (if any)
Parent's Full Name at Birth
Birthplace
Number of times ever Married (if applicable)
Age
Place of Original Ceremony
Birthplace
Place
Street Address
Social Security Number of Applicant B
Email
Birthplace
Age
Name of Most Recent Civil Union Partner (if any)
Domestic Status (at this time)
Sex
Number of times ever in a Civil Union (if applicable)
Date of Birth
Parent's Full Name at Birth
Telephone #
Date
Parent's Full Name at Birth
Are you related to Applicant B?
Contact Information
Date
Place of Original Ceremony
Ceremony Type
Name (First, Middle, Last)
If "Yes," how?
Current Name (if different)
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.)
Number of times ever Married (if applicable)
Municipality
State
(For Remarriage to the same spouse, or Reaffirmation of Civil Union to the same partner ONLY)
County
Birthplace
APPLICANTS MUST PROVIDE THEIR SOCIAL SECURITY NUMBERS (N.J.S. 37:1-17)
Zip
Name of Most Recent Spouse (if any)
The witness named here must present themselves with both applicants to sign the Oath or Affirmation of Applicants and Identifying Witness to the Registrar.
City
Intended Date of Ceremony
(Where you may be reached after the ceremony)
Address
State
Name (First, Middle, Last)
Mailing Address
City
City
In which Incorporated Municipality in New Jersey do you intend for the ceremony to be performed?
Title (Priest, Minister, Rabi, etc.)
Witness Information
State
Mailing Address
Zip
Ceremony Information
State
Mailing Address
Zip
Officiant Details (Person who will be performing the ceremony)
Name (First, Middle, Last)
Zip
4. A witness, 18 years of age or older
1. Proof of identity by presenting your driver's license, passport or state / federal ID
When presenting yourselves to the Registrar you must bring the following items with you.
If you are satisfied that the information completed is correct, please click on the button below to print your prepared application.
5. The $28.00 application fee
2. Proof of your residency
What do I/we need to do next?
Please note that you CANNOT mail your application.
Either separately or together, both Applicants MUST present themselves to sign at the office of the Registrar, accompanied by the witness named in the application.
3. Your social security card or social security number*