(Please
Type)
No._________
APPLICATION FOR MARRIAGE LICENSE
We____Dorie
Sweetness________________ of___NY
NY _________________
(Permanent
Residence)
and___Andy
Amazing___________________ of___NY
NY_______________________
(Permanent Residence)
do
hereby apply for and request that a marriage license be granted us to enter
into
marriage in ______St John______, Virgin Islands, and we do further
respectfully represent that the following statements are true and
correct:
MALE
FEMALE
Full
Name _____Andy Nathan Amazing______ ____ Dorie
Sweetness_ ___
SS
No. _______870-59-6592
_______
______274-87-6582____________
Date
of Birth _July 9 1948 ____________ _____August
8 1959____________
Place
of Birth ___Hartford Conn. ______ ____Raleigh
NC________________
Nationality
____American_________________
____American___________________
Usual
Residence __New York NY____________ _____New York
NY__________________
Parents:
Present Name
__Mary Louise Amazing ___Betty Lou
Sweetness____________
Maiden Name
___Mary Louise Smith__ ____Betty Lou
Jones_______________
Place of Birth
Stamford Conn._(mothers) ____Cary
NC_______________________
Previous
Marital Status __single________
____divorced_____________________
Related
to other Applicant? __no_________
_______no____________________
In
what degree? _____n/a__________________
______n/a
____________________
Signature
____sign your name_____________ _______sign your
name___________
_
|_|PLEASE
CHECK THIS BOX IF YOU ARE REQUESTING EXEMPTION TO THE EIGHT DAY POSTING
REQUIREMENT EXPLAINED IN THE ATTACHED MARRIAGE INFORMATION.
WE ARE REQUESTING EXEMTION BECAUSE
OF THE
FOLLOWING
CIRCUMSTANCES:
_____________________________________________________________________________
_____________________________________________________________________________
THE
COURT, HAVING REVIEWED THIS APPLICATION DETERMINES THAT SPECIAL CIRCUMSTANCES
EXIST TO ISSUE A LICENSE WITHOUT THE POSTING REQUIRED BY TITLE 16 SECTION 38 OF
THE VIRGIN ISLANDS CODE.
______________________________________________
______________________________________________
Subscribed
and sworn to by each of the above parties
this
_________ day of _________,
____
License
issued this __________ day of __________, ____
Filed this __________ day of __________, ____
Clerk
of the Territorial Court
By ________________________
Deputy Clerk