Ann Poole Weddings
Information Needed for Confidential Wedding License For this license both applicants must be at least 18 years of age
NOTE: ALL BOXES MUST BE FILLED IN If information in box is unknown, put "unknown". If information in box is same, put "-".
PARTY A's PERSONAL DATA (Please type in Upper/Lower Case)
First Name ( 1a )
Middle Name ( 1b )
Current Last Name ( 1c )
Last Name at Birth (if different than current last) (1d )
Date of Birth ( 2 )	(mm/dd/yyyy)
State of Birth (If Outside of US Enter Country) ( 3 )
Number of Previous Marriages ( 4 )
Last Marriage Ended By (5a )	Death  Dissolution  Annulment Term SRDP N/A (NOT married before)
Date Last Marriage Ended ( 5b )	(mm/dd/yyyy)
Street Address ( 6 )
City ( 7 )
State (If Outside of US Enter Country) ( 8 )
Zip Code ( 9 )
Full Birth Name of Father/Parent ( 10a )
Father's State of Birth (if outside US enter country) ( 10b )
Full Birth Name of Mother/Parent ( 11a )
Mother's State of Birth (if outside US enter country) ( 11b )
PARTY B's PERSONAL DATA (Please type in Upper/Lower Case)
First Name ( 12a )
Middle Name ( 12b )
Current Last Name ( 12c )
Last Name at Birth (if different than current last) ( 12d )
Date of Birth ( 13 )	(mm/dd/yyyy)
State of Birth (If Outside of US Enter Country) ( 14 )
Number of Previous Marriages ( 15 )
Last Marriage Ended By ( 16a )	Death  Dissolution  Annulment Term SRDP N/A (NOT married before)
Date Last Marriage Ended ( 16b )	(mm/dd/yyyy)
Address ( 17 )
City ( 18 )
State (If Outside of US Enter Country) ( 19 )
Zip Code ( 20 )
Full Birth Name of Father/Parent ( 21a )
Father's State of Birth (if outside US enter country) (21b )
Full Birth Name of Mother/Parent ( 22a )
Mother's State of Birth (if outside US enter country) ( 22b )
Couple's Data
Party A's Day Phone Number
Party A's Evening Phone Number
Party A's Cell Phone Number
Party B's Day Phone Number
Party B's Evening Phone Number
Party B's Cell Phone Number
<<Required>> Your Contact E-Mail
Party A's E-mail:
Party B's E-mail:
Wedding Date and Time:
Wedding Location:
Approximate Number of Guests:
Where To Mail Certified Copy of Marriage License
Mailing Address
Mailing City
Mailing State
Mailing Zip Code
Questions or note to Ann:
NOTE: When you click Submit, the form will be sent to me via e-mail. The window will close.
NOTE: WE THE UNDERSIGNED, DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE AND BELIEF.  WE FURTHER DECLARE THAT NO LEGAL OBJECTION TO THE MARRIAGE NOR TO THE ISSUANCE OF A LICENSE IS KNOWN TO US.  WE ACKNOWLEDGE RECEIPT OF THE INFORMATION REQUIRED BY FAMILY CODE SECTION 358 AND HEREBY APPLY FOR A LICENSE AND CERTIFICATE OF CONFIDENTIAL MARRIAGE. Persuant to Family Code, Section 298.5(c), no person who has filed a Declaration of Domestic Partnership may enter a marriage with someone other than their registered domestic partner unless the most recent domestic partnership has been terminated or a final judgment of dissolution or nullity has been entered, or the domestic partnership terminated due to death of one of the domestic partners.