San Andreas Judicial Branch
Marriage License Application
"EQUAL JUSTICE UNDER LAW"
Party A
- Name: [Timmy Haze]
Occupation: [Unemployed]
Date of Birth: [23/APR/1996]
Location of Birth: [Indianapolis, IN]
Current Mailing Address: [6 Magellan Ave]
Contact Information: [423-1459]
Previous Marital Status: [Single]
Number of This Marriage: [First]
Last Marriage Ended By: [N/A]
Date Last Marriage Ended: [N/A]
Legal name to be taken after marriage: [Timmy Haze]
Label for Marriage Certificate: [Groom]
Proof of Identification: **Attached Document**
Signature:
[Timmy Haze]
Party B
- Name: [Wisteria Moon]
Occupation: [Unemployed]
Date of Birth: [31/OCT/1992]
Location of Birth: [Portland, ME]
Current Mailing Address: [6 Magellan Ave]
Contact Information: [343-9592]
Previous Marital Status: [Single]
Number of This Marriage: [First]
Last Marriage Ended By: [N/A]
Date Last Marriage Ended:[N/A]
Legal name to be taken after marriage: [Wisteria Moon-Haze]
Label for Marriage Certificate: [Bride]
Proof of Identification: **Attached Document**
Signature:
[Wisteria Moon]