Please fill in Party1's information.
Your name must be exactly as it appears on the identification to be presented at time of issuance.
Suffix
- Please make a selection -
I
II
III
IV
V
VI
JR
SR
Race
- Please make a selection -
ALASKAN NATIVE
AFRICAN AMERICAN
AMERICAN INDIAN
BLACK
CHINESE
FILIPINO
HISPANIC
JAPANESE
KOREAN
NATIVE HAWAIIAN
VIETNAMESE
WHITE
OTHER
State
- Please make a selection -
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DISTRICT OF COLUMBIA
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
Birthplace State
- Please make a selection -
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DISTRICT OF COLUMBIA
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
Birthplace Country
- Please make a selection -
AFGHANISTAN
ALBANIA
ALGERIA
ANDORRA
ANGOLA
ANTIGUA
ARGENTINA
ARMENIA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BARBUDA
BELARUS
BELGIUM
BELIZE
BENIN
BHUTAN
BOLIVIA
BOSNIA
BOTSWANA
BRAZIL
BRUNEI
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
COLOMBIA
COMOROS
CONGO (BRAZZAVILLE)
CONGO, DEMOCRATIC REPUBLIC OF THE
COSTA RICA
CÔTE D'IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR (TIMOR TIMUR)
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FIJI
FINLAND
FRANCE
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GREECE
GRENADA
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HERZEGOVINA
HONDURAS
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRELAND
ISRAEL
ITALY
JAMAICA
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, NORTH
KOREA, SOUTH
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACEDONIA, FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MAURITANIA
MAURITIUS
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA
MONACO
MONGOLIA
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NORWAY
OMAN
PAKISTAN
PALAU
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
POLAND
PORTUGAL
QATAR
ROMANIA
RUSSIA
RWANDA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA AND MONTENEGRO
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SPAIN
SRI LANKA
SUDAN
SURINAME
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
URUGUAY
UZBEKISTAN
VANUATU
VATICAN CITY
VENEZUELA
VIETNAM
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
Previously Married?
- Please make a selection -
YES
NO
Number of this Marriage
- Please make a selection -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Last Marriage Ended Reason
- Please make a selection -
ANNULMENT
DIVORCE
DEATH
OTHER