Marriage License Application
Home
About
FAQ's
Contact
Stacy M. Butterfield, CPA
Clerk of the Circuit Court & Comptroller
Polk County, Florida
Spouse 1
First Name
Middle Name
Last Name
Suffix
JR
SR
II
III
IV
V
Proof of Identification
Birth Certificate - Secondary ID
Book In Number
Consular ID Card
Driver's License
Military ID
Passport
Resident Alien Card
State ID
Address
City
County
State
ALBERTA
BRITISH COLUMBIA
MANITOBA
NEW BRUNSWICK
LABRADOR
NEWFOUNDLAND
NORTH WEST TERRITORIES
NOVA SCOTIA
NUNAVUT
ONTARIO
PRINCE EDWARD ISLAND
QUEBEC
SASKATCHEWEN
YUKON
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
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
DISTRICT OF COLUMBIA
WEST VIRGINIA
WISCONSIN
WYOMING
Zip
Phone#
Resident Country
AFGHANISTAN
ALBANIA
ALGERIA
ALL OTHERS
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTIGUA & BARBUDA
ARGENTINA
ARMENIA
ARUBA
ASHMORE& CARTIER ISL
AUSTRALIA
AUSTRIA
AZERBAIJAN
AZORES ISL
BAHAMAS
BAHRAIN
BAKER ISL
BALEARIC ISL
BANGLADESH
BARBADOS
BASSAS DA INDIA
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA & HERZEGOVINA
BOTSWANA
BOUVET ISL
BRAZIL
BRITISH INDIAN OCEAN TERR
BRITISH VIRGIN ISL
BRUNEI
BULGARIA
BURKINA FASO
BURMA
BURUNDI
CAMBODIA
CAMEROON
CANADA
CANAL ZONE
CANARY ISL
CAPE VERDE ISL
CAROLINE ISL
CAYMAN ISL
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMANS ISL
CLIPPERTON ISL
COCOS (KEELING) ISL
COLOMBIA
COMOROS FEDERAL ISLAMIC
CONGO
COOK ISL
CORAL SEA ISL
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
ENGLAND
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EUROPA ISL
FALKLAND ISL
FAROE ISL
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN & ANTARTIC LANDS
GABON
GAMBIA THE
GEORGIA
GERMANY
GHANA
GIBRALTAR
GILBERT & ELLICE ISL
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISL & MCDONALD ISL
HONDURAS
HONG KONG
HOWLAND ISL
HUNGARY
ICELAND
INDIA SIKKIM
INDONESIA
IRAN
IRAQ
IRELAND
ISLE OF MAN
ISRAEL
ITALY
IVORY COAST
JAMAICA
JAN MAYEN
JAPAN
JARVIS ISL
JERSEY
JOHNSTON ATOLL
JORDAN
JUAN DE NOVA ISL
KAZAKHSTAN
KENYA
KINGSMAN REEF
KIRIBATI
KOSOVO
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA
MADAGASCAR
MADEIRA ISL
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MANAHIKI ISL
MARSHALL ISL
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA
MIDWAY ISL
MOLDOVA
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MORELOS
MOROCCO
MOZAMBIQUE
NAMIBIA
NAURU
NAVASSA ISL
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW HEBRIDES
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISL
NORTH KOREA
NORTHERN IRELAND
NORTHERN MARIANA ISL
NORWAY
OKINAWA
OMAN
PAKISTAN
PALAU
PALMYRA ISL
PANAMA
PAPUA NEW GUINEA
PARACEL ISL
PARAGUAY
PERU
PHILIPPINES
PITCAIRN HENDERSON DUCIE & OENO ISL
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIA
RUSSIAN FEDERATION
RWANDA
SAINT KITTS & NEVIS
SAINT LUCIA
SAN MARINO
SAO TOME & PRINCIPE
SAUDI ARABIA
SCOTLAND
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SO GEORGIA & THE SO SANDWICH ISL
SOLOMON ISL
SOMALIA
SOUTH AFRICA
SOUTH KOREA
SPAIN
SPRATLY ISL
SRI LANKA
ST HELENA
ST PIERRE & MIQUELON TERR
ST VINCENT & THE GRENADINES
SUDAN
SURINAM
SVALBARD
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TOKELAU
TONGA
TONGAREVA
TRINIDAD & TOBAGO
TROMELIN ISL
TRUST TERR OF THE PACIFIC ISL
TUNISIA
TURKEY
TURKMENISTAN
TURKS & CAICOS ISL
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNKNOWN
URUGUAY
US INDIAN NATIONS
USA
UZBEKISTAN
VATICAN CITY
VENEZUELA
VIETNAM
VIRGIN ISL
WAKE ISL
WALES
WALLIS & FUTUNA
WEST BANK
WEST GERMANY
WEST INDIES
WESTERN SAHARA
WESTERN SAMOA
YEMEN
YUGOSLAVIA
ZAIRE
ZAMBIA
ZIMBABWE
Birth State
ALBERTA
BRITISH COLUMBIA
MANITOBA
NEW BRUNSWICK
LABRADOR
NEWFOUNDLAND
NORTH WEST TERRITORIES
NOVA SCOTIA
NUNAVUT
ONTARIO
PRINCE EDWARD ISLAND
QUEBEC
SASKATCHEWEN
YUKON
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
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
DISTRICT OF COLUMBIA
WEST VIRGINIA
WISCONSIN
WYOMING
Birth Country
AFGHANISTAN
ALBANIA
ALGERIA
ALL OTHERS
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTIGUA & BARBUDA
ARGENTINA
ARMENIA
ARUBA
ASHMORE& CARTIER ISL
AUSTRALIA
AUSTRIA
AZERBAIJAN
AZORES ISL
BAHAMAS
BAHRAIN
BAKER ISL
BALEARIC ISL
BANGLADESH
BARBADOS
BASSAS DA INDIA
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA & HERZEGOVINA
BOTSWANA
BOUVET ISL
BRAZIL
BRITISH INDIAN OCEAN TERR
BRITISH VIRGIN ISL
BRUNEI
BULGARIA
BURKINA FASO
BURMA
BURUNDI
CAMBODIA
CAMEROON
CANADA
CANAL ZONE
CANARY ISL
CAPE VERDE ISL
CAROLINE ISL
CAYMAN ISL
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMANS ISL
CLIPPERTON ISL
COCOS (KEELING) ISL
COLOMBIA
COMOROS FEDERAL ISLAMIC
CONGO
COOK ISL
CORAL SEA ISL
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
ENGLAND
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EUROPA ISL
FALKLAND ISL
FAROE ISL
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN & ANTARTIC LANDS
GABON
GAMBIA THE
GEORGIA
GERMANY
GHANA
GIBRALTAR
GILBERT & ELLICE ISL
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISL & MCDONALD ISL
HONDURAS
HONG KONG
HOWLAND ISL
HUNGARY
ICELAND
INDIA SIKKIM
INDONESIA
IRAN
IRAQ
IRELAND
ISLE OF MAN
ISRAEL
ITALY
IVORY COAST
JAMAICA
JAN MAYEN
JAPAN
JARVIS ISL
JERSEY
JOHNSTON ATOLL
JORDAN
JUAN DE NOVA ISL
KAZAKHSTAN
KENYA
KINGSMAN REEF
KIRIBATI
KOSOVO
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA
MADAGASCAR
MADEIRA ISL
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MANAHIKI ISL
MARSHALL ISL
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA
MIDWAY ISL
MOLDOVA
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MORELOS
MOROCCO
MOZAMBIQUE
NAMIBIA
NAURU
NAVASSA ISL
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW HEBRIDES
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISL
NORTH KOREA
NORTHERN IRELAND
NORTHERN MARIANA ISL
NORWAY
OKINAWA
OMAN
PAKISTAN
PALAU
PALMYRA ISL
PANAMA
PAPUA NEW GUINEA
PARACEL ISL
PARAGUAY
PERU
PHILIPPINES
PITCAIRN HENDERSON DUCIE & OENO ISL
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIA
RUSSIAN FEDERATION
RWANDA
SAINT KITTS & NEVIS
SAINT LUCIA
SAN MARINO
SAO TOME & PRINCIPE
SAUDI ARABIA
SCOTLAND
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SO GEORGIA & THE SO SANDWICH ISL
SOLOMON ISL
SOMALIA
SOUTH AFRICA
SOUTH KOREA
SPAIN
SPRATLY ISL
SRI LANKA
ST HELENA
ST PIERRE & MIQUELON TERR
ST VINCENT & THE GRENADINES
SUDAN
SURINAM
SVALBARD
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TOKELAU
TONGA
TONGAREVA
TRINIDAD & TOBAGO
TROMELIN ISL
TRUST TERR OF THE PACIFIC ISL
TUNISIA
TURKEY
TURKMENISTAN
TURKS & CAICOS ISL
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNKNOWN
URUGUAY
US INDIAN NATIONS
USA
UZBEKISTAN
VATICAN CITY
VENEZUELA
VIETNAM
VIRGIN ISL
WAKE ISL
WALES
WALLIS & FUTUNA
WEST BANK
WEST GERMANY
WEST INDIES
WESTERN SAHARA
WESTERN SAMOA
YEMEN
YUGOSLAVIA
ZAIRE
ZAMBIA
ZIMBABWE
DOB
Age
Social Security #
This Marriage #
1
2
3
4
5
6
7
8
9
Birth/Maiden Name
Last Marriage Ended In
Death
Divorce
Annul
Date Last Marriage Ended on
Spouse 2
First Name
Middle Name
Last Name
Suffix
JR
SR
II
III
IV
V
Proof of Identification
Birth Certificate - Secondary ID
Book In Number
Consular ID Card
Driver's License
Military ID
Passport
Resident Alien Card
State ID
Same Address
Address
City
County
State
ALBERTA
BRITISH COLUMBIA
MANITOBA
NEW BRUNSWICK
LABRADOR
NEWFOUNDLAND
NORTH WEST TERRITORIES
NOVA SCOTIA
NUNAVUT
ONTARIO
PRINCE EDWARD ISLAND
QUEBEC
SASKATCHEWEN
YUKON
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
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
DISTRICT OF COLUMBIA
WEST VIRGINIA
WISCONSIN
WYOMING
Zip
Phone#
Resident Country
AFGHANISTAN
ALBANIA
ALGERIA
ALL OTHERS
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTIGUA & BARBUDA
ARGENTINA
ARMENIA
ARUBA
ASHMORE& CARTIER ISL
AUSTRALIA
AUSTRIA
AZERBAIJAN
AZORES ISL
BAHAMAS
BAHRAIN
BAKER ISL
BALEARIC ISL
BANGLADESH
BARBADOS
BASSAS DA INDIA
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA & HERZEGOVINA
BOTSWANA
BOUVET ISL
BRAZIL
BRITISH INDIAN OCEAN TERR
BRITISH VIRGIN ISL
BRUNEI
BULGARIA
BURKINA FASO
BURMA
BURUNDI
CAMBODIA
CAMEROON
CANADA
CANAL ZONE
CANARY ISL
CAPE VERDE ISL
CAROLINE ISL
CAYMAN ISL
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMANS ISL
CLIPPERTON ISL
COCOS (KEELING) ISL
COLOMBIA
COMOROS FEDERAL ISLAMIC
CONGO
COOK ISL
CORAL SEA ISL
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
ENGLAND
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EUROPA ISL
FALKLAND ISL
FAROE ISL
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN & ANTARTIC LANDS
GABON
GAMBIA THE
GEORGIA
GERMANY
GHANA
GIBRALTAR
GILBERT & ELLICE ISL
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISL & MCDONALD ISL
HONDURAS
HONG KONG
HOWLAND ISL
HUNGARY
ICELAND
INDIA SIKKIM
INDONESIA
IRAN
IRAQ
IRELAND
ISLE OF MAN
ISRAEL
ITALY
IVORY COAST
JAMAICA
JAN MAYEN
JAPAN
JARVIS ISL
JERSEY
JOHNSTON ATOLL
JORDAN
JUAN DE NOVA ISL
KAZAKHSTAN
KENYA
KINGSMAN REEF
KIRIBATI
KOSOVO
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA
MADAGASCAR
MADEIRA ISL
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MANAHIKI ISL
MARSHALL ISL
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA
MIDWAY ISL
MOLDOVA
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MORELOS
MOROCCO
MOZAMBIQUE
NAMIBIA
NAURU
NAVASSA ISL
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW HEBRIDES
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISL
NORTH KOREA
NORTHERN IRELAND
NORTHERN MARIANA ISL
NORWAY
OKINAWA
OMAN
PAKISTAN
PALAU
PALMYRA ISL
PANAMA
PAPUA NEW GUINEA
PARACEL ISL
PARAGUAY
PERU
PHILIPPINES
PITCAIRN HENDERSON DUCIE & OENO ISL
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIA
RUSSIAN FEDERATION
RWANDA
SAINT KITTS & NEVIS
SAINT LUCIA
SAN MARINO
SAO TOME & PRINCIPE
SAUDI ARABIA
SCOTLAND
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SO GEORGIA & THE SO SANDWICH ISL
SOLOMON ISL
SOMALIA
SOUTH AFRICA
SOUTH KOREA
SPAIN
SPRATLY ISL
SRI LANKA
ST HELENA
ST PIERRE & MIQUELON TERR
ST VINCENT & THE GRENADINES
SUDAN
SURINAM
SVALBARD
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TOKELAU
TONGA
TONGAREVA
TRINIDAD & TOBAGO
TROMELIN ISL
TRUST TERR OF THE PACIFIC ISL
TUNISIA
TURKEY
TURKMENISTAN
TURKS & CAICOS ISL
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNKNOWN
URUGUAY
US INDIAN NATIONS
USA
UZBEKISTAN
VATICAN CITY
VENEZUELA
VIETNAM
VIRGIN ISL
WAKE ISL
WALES
WALLIS & FUTUNA
WEST BANK
WEST GERMANY
WEST INDIES
WESTERN SAHARA
WESTERN SAMOA
YEMEN
YUGOSLAVIA
ZAIRE
ZAMBIA
ZIMBABWE
Birth State
ALBERTA
BRITISH COLUMBIA
MANITOBA
NEW BRUNSWICK
LABRADOR
NEWFOUNDLAND
NORTH WEST TERRITORIES
NOVA SCOTIA
NUNAVUT
ONTARIO
PRINCE EDWARD ISLAND
QUEBEC
SASKATCHEWEN
YUKON
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
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
DISTRICT OF COLUMBIA
WEST VIRGINIA
WISCONSIN
WYOMING
Birth Country
AFGHANISTAN
ALBANIA
ALGERIA
ALL OTHERS
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTIGUA & BARBUDA
ARGENTINA
ARMENIA
ARUBA
ASHMORE& CARTIER ISL
AUSTRALIA
AUSTRIA
AZERBAIJAN
AZORES ISL
BAHAMAS
BAHRAIN
BAKER ISL
BALEARIC ISL
BANGLADESH
BARBADOS
BASSAS DA INDIA
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA & HERZEGOVINA
BOTSWANA
BOUVET ISL
BRAZIL
BRITISH INDIAN OCEAN TERR
BRITISH VIRGIN ISL
BRUNEI
BULGARIA
BURKINA FASO
BURMA
BURUNDI
CAMBODIA
CAMEROON
CANADA
CANAL ZONE
CANARY ISL
CAPE VERDE ISL
CAROLINE ISL
CAYMAN ISL
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMANS ISL
CLIPPERTON ISL
COCOS (KEELING) ISL
COLOMBIA
COMOROS FEDERAL ISLAMIC
CONGO
COOK ISL
CORAL SEA ISL
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
ENGLAND
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EUROPA ISL
FALKLAND ISL
FAROE ISL
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN & ANTARTIC LANDS
GABON
GAMBIA THE
GEORGIA
GERMANY
GHANA
GIBRALTAR
GILBERT & ELLICE ISL
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISL & MCDONALD ISL
HONDURAS
HONG KONG
HOWLAND ISL
HUNGARY
ICELAND
INDIA SIKKIM
INDONESIA
IRAN
IRAQ
IRELAND
ISLE OF MAN
ISRAEL
ITALY
IVORY COAST
JAMAICA
JAN MAYEN
JAPAN
JARVIS ISL
JERSEY
JOHNSTON ATOLL
JORDAN
JUAN DE NOVA ISL
KAZAKHSTAN
KENYA
KINGSMAN REEF
KIRIBATI
KOSOVO
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA
MADAGASCAR
MADEIRA ISL
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MANAHIKI ISL
MARSHALL ISL
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA
MIDWAY ISL
MOLDOVA
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MORELOS
MOROCCO
MOZAMBIQUE
NAMIBIA
NAURU
NAVASSA ISL
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW HEBRIDES
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISL
NORTH KOREA
NORTHERN IRELAND
NORTHERN MARIANA ISL
NORWAY
OKINAWA
OMAN
PAKISTAN
PALAU
PALMYRA ISL
PANAMA
PAPUA NEW GUINEA
PARACEL ISL
PARAGUAY
PERU
PHILIPPINES
PITCAIRN HENDERSON DUCIE & OENO ISL
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIA
RUSSIAN FEDERATION
RWANDA
SAINT KITTS & NEVIS
SAINT LUCIA
SAN MARINO
SAO TOME & PRINCIPE
SAUDI ARABIA
SCOTLAND
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SO GEORGIA & THE SO SANDWICH ISL
SOLOMON ISL
SOMALIA
SOUTH AFRICA
SOUTH KOREA
SPAIN
SPRATLY ISL
SRI LANKA
ST HELENA
ST PIERRE & MIQUELON TERR
ST VINCENT & THE GRENADINES
SUDAN
SURINAM
SVALBARD
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TOKELAU
TONGA
TONGAREVA
TRINIDAD & TOBAGO
TROMELIN ISL
TRUST TERR OF THE PACIFIC ISL
TUNISIA
TURKEY
TURKMENISTAN
TURKS & CAICOS ISL
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNKNOWN
URUGUAY
US INDIAN NATIONS
USA
UZBEKISTAN
VATICAN CITY
VENEZUELA
VIETNAM
VIRGIN ISL
WAKE ISL
WALES
WALLIS & FUTUNA
WEST BANK
WEST GERMANY
WEST INDIES
WESTERN SAHARA
WESTERN SAMOA
YEMEN
YUGOSLAVIA
ZAIRE
ZAMBIA
ZIMBABWE
DOB
Age
Social Security #
This Marriage #
1
2
3
4
5
6
7
8
9
Birth/Maiden Name
Last Marriage Ended In
Death
Divorce
Annul
Date Last Marriage Ended on
  Please verify that you are not a robot