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Online Marriage Form
Applicant 1 Personal Information
Name:
First
Middle
Last
Suffix
Jr
Sr
I
II
III
IV
V
VI
Last Name Prior to First Marriage (If Applies):
Gender (optional):
-
Male
Female
Street Address:
City:
State, Zip:
-
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
MEXICO
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
NICARAGUA
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
PHILIPPINES
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
SENEGAL
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
VIETNAM
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIMBABWE
,
County Residing:
Select a NC county or fill in one
-
ALAMANCE
ALEXANDER
ALLEGHANY
ANSON
ASHE
AVERY
BEAUFORT
BERTIE
BLADEN
BRUNSWICK
BUNCOMBE
BURKE
CABARRUS
CALDWELL
CAMDEN
CARTERET
CASWELL
CATAWBA
CHATHAM
CHEROKEE
CHOWAN
CLAY
CLEVELAND
COLUMBUS
CRAVEN
CUMBERLAND
CURRITUCK
DAVIDSON
DAVIE
DARE
DURHAM
DUPLIN
EDGECOMBE
FORSYTH
FRANKLIN
GUILFORD
GASTON
GATES
GRAHAM
GRANVILLE
GREENE
HALIFAX
HARNETT
HAYWOOD
HENDERSON
HERTFORD
HOKE
HYDE
IREDELL
JACKSON
JOHNSTON
JONES
LEE
LENOIR
LINCOLN
MECKLENBURG
MACON
MADISON
MARTIN
MCDOWELL
MITCHELL
MONTGOMERY
MOORE
NASH
NEW HANOVER
NORTHAMPTON
ONSLOW
ORANGE
PAMLICO
PASQUOTANK
PENDER
PERQUIMANS
PERSON
PITT
POLK
RANDOLPH
RICHMOND
ROCKINGHAM
ROBESON
ROWAN
RUTHERFORD
SAMPSON
SCOTLAND
STANLY
STOKES
SURRY
SWAIN
TRANSYLVANIA
TYRRELL
UNION
VANCE
WAKE
WARREN
WASHINGTON
WATAUGA
WAYNE
WILKES
WILSON
YADKIN
YANCEY
Or
Inside City Limits of City?
-
Yes
No
Date of Birth:
-
January
February
March
April
May
June
July
August
September
October
November
December
-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Age:
Birthplace County/State:
Select a NC county or fill in one
-
ALAMANCE
ALEXANDER
ALLEGHANY
ANSON
ASHE
AVERY
BEAUFORT
BERTIE
BLADEN
BRUNSWICK
BUNCOMBE
BURKE
CABARRUS
CALDWELL
CAMDEN
CARTERET
CASWELL
CATAWBA
CHATHAM
CHEROKEE
CHOWAN
CLAY
CLEVELAND
COLUMBUS
CRAVEN
CUMBERLAND
CURRITUCK
DAVIDSON
DAVIE
DARE
DURHAM
DUPLIN
EDGECOMBE
FORSYTH
FRANKLIN
GUILFORD
GASTON
GATES
GRAHAM
GRANVILLE
GREENE
HALIFAX
HARNETT
HAYWOOD
HENDERSON
HERTFORD
HOKE
HYDE
IREDELL
JACKSON
JOHNSTON
JONES
LEE
LENOIR
LINCOLN
MECKLENBURG
MACON
MADISON
MARTIN
MCDOWELL
MITCHELL
MONTGOMERY
MOORE
NASH
NEW HANOVER
NORTHAMPTON
ONSLOW
ORANGE
PAMLICO
PASQUOTANK
PENDER
PERQUIMANS
PERSON
PITT
POLK
RANDOLPH
RICHMOND
ROCKINGHAM
ROBESON
ROWAN
RUTHERFORD
SAMPSON
SCOTLAND
STANLY
STOKES
SURRY
SWAIN
TRANSYLVANIA
TYRRELL
UNION
VANCE
WAKE
WARREN
WASHINGTON
WATAUGA
WAYNE
WILKES
WILSON
YADKIN
YANCEY
Or
State
-
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
MEXICO
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
NICARAGUA
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
PHILIPPINES
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
SENEGAL
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
VIETNAM
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIMBABWE
Race (optional):
-
AFRICAN AMERICAN
AMERICAN INDIAN
ASIAN
ASIAN INDIAN
BLACK
CAUCASIAN
CHAMORRO
CHICANO
CHINESE
SPANISH
CUBAN
FILIPINO
GUAMARIAN
HISPANIC
JAPANESE
KOREAN
LATINO
MEXICAN
MEXICAN-AMERICAN
ALASKA NATIVE
VIETNAMESE
SAMOAN
PUERTO RICAN
OTHER PACIFIC ISLANDER
OTHER ASIAN
OTHER
WHITE
MULTI
Present
Not Present
Applicant 1 Marital History
Which marriage is this?
-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Last Marriage Ended Date:
-
January
February
March
April
May
June
July
August
September
October
November
December
-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
Last Marriage Ended Reason:
-
Death
Divorce
Annulment
Applicant 1 Educational Information
What is the highest grade completed?
Elementary
High School
College
-
1
2
3
4
5
6
7
8
-
1
2
3
4
Applicant 1 Parental Information
Parent 1 Full Name:
(Include name at birth if different.)
Address:
(Street, City)
Parent 1 Birthplace State:
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
MEXICO
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
NICARAGUA
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
PHILIPPINES
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
SENEGAL
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
VIETNAM
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIMBABWE
Or
Parent 2 Name:
(Include name at birth if different.)
Address:
(Street, City)
Same as Parent 1
Parent 2 Birthplace State:
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
MEXICO
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
NICARAGUA
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
PHILIPPINES
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
SENEGAL
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
VIETNAM
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIMBABWE
Or
* If Name or Address is not known, please type UNKNOWN in that field *
Applicant 2 Personal Information
Name:
First
Middle
Last
Suffix
Jr
Sr
I
II
III
IV
V
VI
Last Name Prior to First Marriage (If Applies):
Gender (optional):
-
Male
Female
Street Address:
Address same as Applicant 1
City:
State, Zip:
-
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
MEXICO
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
NICARAGUA
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
PHILIPPINES
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
SENEGAL
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
VIETNAM
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIMBABWE
,
County Residing:
Select a NC county or fill in one
-
ALAMANCE
ALEXANDER
ALLEGHANY
ANSON
ASHE
AVERY
BEAUFORT
BERTIE
BLADEN
BRUNSWICK
BUNCOMBE
BURKE
CABARRUS
CALDWELL
CAMDEN
CARTERET
CASWELL
CATAWBA
CHATHAM
CHEROKEE
CHOWAN
CLAY
CLEVELAND
COLUMBUS
CRAVEN
CUMBERLAND
CURRITUCK
DAVIDSON
DAVIE
DARE
DURHAM
DUPLIN
EDGECOMBE
FORSYTH
FRANKLIN
GUILFORD
GASTON
GATES
GRAHAM
GRANVILLE
GREENE
HALIFAX
HARNETT
HAYWOOD
HENDERSON
HERTFORD
HOKE
HYDE
IREDELL
JACKSON
JOHNSTON
JONES
LEE
LENOIR
LINCOLN
MECKLENBURG
MACON
MADISON
MARTIN
MCDOWELL
MITCHELL
MONTGOMERY
MOORE
NASH
NEW HANOVER
NORTHAMPTON
ONSLOW
ORANGE
PAMLICO
PASQUOTANK
PENDER
PERQUIMANS
PERSON
PITT
POLK
RANDOLPH
RICHMOND
ROCKINGHAM
ROBESON
ROWAN
RUTHERFORD
SAMPSON
SCOTLAND
STANLY
STOKES
SURRY
SWAIN
TRANSYLVANIA
TYRRELL
UNION
VANCE
WAKE
WARREN
WASHINGTON
WATAUGA
WAYNE
WILKES
WILSON
YADKIN
YANCEY
Or
Inside City Limits of City?
-
Yes
No
Date of Birth:
-
January
February
March
April
May
June
July
August
September
October
November
December
-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Age:
Birthplace County/State:
Select a NC county or fill in one
-
ALAMANCE
ALEXANDER
ALLEGHANY
ANSON
ASHE
AVERY
BEAUFORT
BERTIE
BLADEN
BRUNSWICK
BUNCOMBE
BURKE
CABARRUS
CALDWELL
CAMDEN
CARTERET
CASWELL
CATAWBA
CHATHAM
CHEROKEE
CHOWAN
CLAY
CLEVELAND
COLUMBUS
CRAVEN
CUMBERLAND
CURRITUCK
DAVIDSON
DAVIE
DARE
DURHAM
DUPLIN
EDGECOMBE
FORSYTH
FRANKLIN
GUILFORD
GASTON
GATES
GRAHAM
GRANVILLE
GREENE
HALIFAX
HARNETT
HAYWOOD
HENDERSON
HERTFORD
HOKE
HYDE
IREDELL
JACKSON
JOHNSTON
JONES
LEE
LENOIR
LINCOLN
MECKLENBURG
MACON
MADISON
MARTIN
MCDOWELL
MITCHELL
MONTGOMERY
MOORE
NASH
NEW HANOVER
NORTHAMPTON
ONSLOW
ORANGE
PAMLICO
PASQUOTANK
PENDER
PERQUIMANS
PERSON
PITT
POLK
RANDOLPH
RICHMOND
ROCKINGHAM
ROBESON
ROWAN
RUTHERFORD
SAMPSON
SCOTLAND
STANLY
STOKES
SURRY
SWAIN
TRANSYLVANIA
TYRRELL
UNION
VANCE
WAKE
WARREN
WASHINGTON
WATAUGA
WAYNE
WILKES
WILSON
YADKIN
YANCEY
Or
State
-
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
MEXICO
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
NICARAGUA
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
PHILIPPINES
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
SENEGAL
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
VIETNAM
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIMBABWE
Race (optional):
-
AFRICAN AMERICAN
AMERICAN INDIAN
ASIAN
ASIAN INDIAN
BLACK
CAUCASIAN
CHAMORRO
CHICANO
CHINESE
SPANISH
CUBAN
FILIPINO
GUAMARIAN
HISPANIC
JAPANESE
KOREAN
LATINO
MEXICAN
MEXICAN-AMERICAN
ALASKA NATIVE
VIETNAMESE
SAMOAN
PUERTO RICAN
OTHER PACIFIC ISLANDER
OTHER ASIAN
OTHER
WHITE
MULTI
Present
Not Present
Applicant 2 Marital Information
Which marriage is this?
-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Last Marriage Ended Date:
-
January
February
March
April
May
June
July
August
September
October
November
December
-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
Last Marriage Ended Reason:
-
Death
Divorce
Annulment
Applicant 2 Educational Information
What is the highest grade completed?
Elementary
High School
College
-
1
2
3
4
5
6
7
8
-
1
2
3
4
Applicant 2 Parental Information
Parent 1 Full Name:
(Include name at birth if different.)
Address:
(Street, City)
Parent 1 Birthplace State:
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
MEXICO
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
NICARAGUA
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
PHILIPPINES
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
SENEGAL
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
VIETNAM
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIMBABWE
Or
Parent 2 Name:
(Include name at birth if different.)
Address:
(Street, City)
Same as Parent 1
Parent 2 Birthplace State:
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
CANADA
Colorado
Connecticut
DELAWARE
District Of Columbia
DOMINICAN REPUBLIC
EL SALVADOR
Fed St of Micronesia
Florida
Georgia
Guam
GUATEMALA
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
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