RS 9:223
476 words·~2 min read·
/la/title-9/9-479A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
RS 9:223
§223. Form
A. An application for a marriage license shall be made on a form provided by Subsection B of this Section.
B. The application form shall be as follows:
Application for Marriage
__________________(Parish), State of Louisiana
Date of Application:
Hour of Application:
GROOM
Last Name of Groom
First Name of Groom
Middle/Second Name of Groom
Address
Is residence inside city limits?
☐ Yes ☐ No
Parish/County
State
Race
Date of Birth (month-day-year)
State of Birth
Father's Name
State of Birth
Mother's Maiden Name
State of Birth
BRIDE
Last Name of Bride
First Name of Bride
Middle/Second Name of Bride
Maiden Name of Bride
Address
Is residence inside city limits?
☐ Yes ☐ No
Parish/County
State
Race
Date of Birth (month-day-year)
State of Birth
Father's Name
State of Birth
Mother's Maiden Name
State of Birth
Covenant Marriage
Covenant Marriage☐ Yes☐ NoIf yes, complete the following:
We, ___________________________ and _____________________________
do hereby declare our intent to contract a Covenant Marriage and, accordingly, have executed a declaration of intent attached hereto.
Groom
Has the groom been formerly married?_________
How many times?________
Are you divorced ________?
Bride
Has the bride been formerly married?_________
How many times?________
Are you divorced ________?
SSN
Grooms's Social Security Number
Bride's Social Security Number
I ___________________________ (print name of groom) do swear or affirm that the information contained in this application for marriage is true and correct. I further swear or affirm that this is my ______ (1 st , 2 nd , etc. number) marriage but that I am not currently married to anyone else, and that I am free to marry under the laws of the state of Louisiana. I further understand and acknowledge that giving any false information or false statement in this application of marriage shall constitute the crime of filing a false public record in violation of the Louisiana Criminal Code (R.S. 14:133).
____________________________
Signature of Groom
Sworn to and subscribed before me this ________ day of __________________, 20___.
___________________ Notary Public/Deputy Clerk/Deputy Registrar
I ___________________________ (print name of bride) do swear or affirm that the information contained in this application for marriage is true and correct. I further swear or affirm that this is my ______ (1 st , 2 nd , etc. number) marriage but that I am not currently married to anyone else, and that I am free to marry under the laws of the state of Louisiana. I further understand and acknowledge that giving any false information or false statement in this application of marriage shall constitute the crime of filing a false public record in violation of the Louisiana Criminal Code (R.S. 14:133).
____________________________
Signature of Bride
Sworn to and subscribed before me this ________ day of __________________, 20___.
___________________ Notary Public/Deputy Clerk/Deputy Registrar
Acts 1987, No. 886, §3, eff. Jan. 1, 1988; Acts 2015, No. 436, §1, eff. Jan. 1, 2016.