Marriage Kiosk

EXPECTED CEREMONY DATE (FECHA DESEADA PARA LA CEREMONIA)

PARTY A

Affidavit - STATE OF WASHINGTON, Snohomish County The undersigned, being first duly sworn, deposes as follows: That I am eighteen (18) years of age or older or if not, have parental, guardian, or court waiver as documented on the attached supplemental application ; that if I am afflicted with any contagious sexually transmitted disease, the condition is known to the other applicant. I understand this marriage license is not valid for three (3) days from the date the application is filed and is void if the marriage is not solemnized within (60) days of the issuance of the license. I further understand that the marriage must be solemnized in Washington State.
I AGREE

PERSON A SELECT ONE (SELECCIONAR UNO)

PERSON A FIRST NAME	PERSON A MIDDLE NAME (SEGUNDO NOMBRE)

PERSON A LAST NAME (APELLIDO)	PERSON A BIRTH NAME (IF DIFFERENT) (NOMBRE DE PILA (SI ES DIFERENTE)`)

PERSON A DATE OF BIRTH (FECHA DE NACIMIENTO)	PERSON A BIRTH STATE (IF NOT USA, PROVIDE COUNTRY) (ESTADO DE NACIMIENTO (SI NO ES EN EE. UU., INDICAR PAÍS))

PERSON A GENDER (SEXO)	PERSON A PRESENT MARITAL STATUS (ESTADO CIVIL ACTUAL)

PERSON (A) IS UNDER CONTROL OF GUARDIAN
A COURT ORDER IS REQUIRED IF PERSON (A) IS UNDER 16
Current Residence
PERSON A PRESENT ADDRESS (DOMICILIO ACTUAL)	PERSON A PRESENT CITY / TOWN (CIUDAD / PUEBLO ACTUAL)

PERSON A PRESENT STATE (ESTADO ACTUAL)	PERSON A PRESENT ZIP (CÓDIGO POSTAL ACTUAL)

PERSON A COUNTY OF RESIDENCE (CONDADO DE RESIDENCIA)	PERSON A EMAIL ADDRESS (DIRECCIÓN ELECTRÓNICA)

Prior Residence if Current Residence less than 6 months
PERSON A PREVIOUS ADDRESS (CÓDIGO POSTAL ANTERIOR)	PERSON A PREVIOUS CITY / TOWN (CIUDAD / PUEBLO ANTERIOR)

PERSON A PREVIOUS STATE (ESTADO ANTERIOR)	PERSON A PREVIOUS ZIP (CÓDIGO POSTAL ANTERIOR)

Parent Information
PERSON A MOTHER BIRTH NAME (NOMBRE DE PILA DE LA MADRE / PROGENITOR)	PERSON A MOTHER BIRTH STATE (OR COUNTRY) (ESTADO (O PAÍS) DE NACIMIENTO DE LA MADRE / PROGENITOR)

PERSON A FATHER BIRTH NAME (NOMBRE DE PILA DEL PADRE / PROGENITOR)	PERSON A FATHER BIRTH STATE (OR COUNTRY) (ESTADO (O PAÍS) DE NACIMIENTO DEL PADRE / PROGENITOR)

PARTY B

** Secondary party legal information, used in Snohomish County, WA
I AGREE

PERSON B SELECT ONE (SELECCIONAR UNO)

PERSON B FIRST NAME (PRIMER NOMBRE)	PERSON B MIDDLE NAME (SEGUNDO NOMBRE)

PERSON B LAST NAME (APELLIDO)	PERSON B BIRTH NAME (IF DIFFERENT) (NOMBRE DE PILA (SI ES DIFERENTE))

PERSON B DATE OF BIRTH (FECHA DE NACIMIENTO)	PERSON B BIRTH STATE (IF NOT USA PROVIDE COUNTRY) (ESTADO DE NACIMIENTO (SI NO ES EN EE. UU., INDICAR PAÍS))

PERSON B GENDER (SEXO)	PERSON B PRESENT MARITAL STATUS (ESTADO CIVIL ACTUAL)

PERSON (B) IS UNDER CONTROL OF GUARDIAN
A COURT ORDER IS REQUIRED IF PERSON (B) IS UNDER 16
Current Residence
PERSON B PRESENT ADDRESS (DOMICILIO ACTUAL)	PERSON B PRESENT CITY/TOWN (CIUDAD / PUEBLO ACTUAL)

PERSON B PRESENT STATE (ESTADO ACTUAL)	PERSON B PRESENT ZIP (CÓDIGO POSTAL ACTUAL)

PERSON B COUNTY OF RESIDENCE (CONDADO DE RESIDENCIA)	PERSON B EMAIL ADDRESS (DIRECCIÓN ELECTRÓNICA)

Prior Residence if Current Residence less than 6 months
PERSON B PREVIOUS ADDRESS (CÓDIGO POSTAL ANTERIOR)	PERSON B PREVIOUS CITY / TOWN (CIUDAD / PUEBLO ANTERIOR)

PERSON B PREVIOUS STATE (ESTADO ANTERIOR)	PERSON B PREVIOUS ZIP (CÓDIGO POSTAL ANTERIOR)

Parent Information
PERSON B MOTHER BIRTH NAME (NOMBRE DE PILA DE LA MADRE / PROGENITOR)	PERSON B MOTHER BIRTH STATE (OR COUNTRY) (ESTADO (O PAÍS) DE NACIMIENTO DE LA MADRE / PROGENITOR)

PERSON B FATHER BIRTH NAME (NOMBRE DE PILA DEL PADRE / PROGENITOR)	PERSON B FATHER BIRTH STATE (OR COUNTRY) (ESTADO (O PAÍS) DE NACIMIENTO DEL PADRE / PROGENITOR)

Marriage License Application

PARTY A

PARTY B