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Marriage Kiosk

 

Applicant

Applicant 1 - First Name Applicant 1 - Middle Name
Applicant 1 - Last Name Applicant 1 - Suffix
Applicant 1 - Last Name at Birth
Applicant 1 - Race Applicant 1 - SSN
Applicant 1 - Street Address Applicant 1 - City
Applicant 1 - Residence - State Applicant 1 - Zip Code
Applicant 1 - County Applicant 1 - Phone Number
Applicant 1 - Date of Birth Applicant 1 - State or Country of Birth
Applicant 1 - Have you been previously married? Applicant 1 - Number of Previous Marriages
Applicant 1 - Last Marriage Ended Date Applicant 1 - Marriage Ended

    Applicant

    Applicant 2 - First Name Applicant 2 - Middle Name
    Applicant 2 - Last Name Applicant 2 - Suffix Name
    Applicant 2 - Last Name at Birth
    Applicant 2 - Race Applicant 2 - SSN
    Applicant 2 - Street Address Applicant 2 - City
    Applicant 2 - State Applicant 2 - Zip
    Applicant 2 - County Applicant 2 - Phone
    Applicant 2 - Date of Birth Applicant 2 - State or Country of Birth
    Applicant 2 - Previously married? Applicant 2 - Number of previous marriages
    Applicant 2 - Last Marriage Ended Date Applicant 2 - Marriage Ended
       

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