Broward County Clerk of Court - Marriage - Pre-Application Questionnaire

PLEASE ADVISE THE CLERK IF YOU ARE EXEMPT UNDER FLORIDA STATUTE 119.071

Both parties must apply in person at the same time.

* Required Fields, ** Only Required if Number of This Marriage is 2 or more.
Spouse 1 Info		Spouse 2 Info		General Info		Summary

Your correct legal name is required and must match your identification.

*First:

Middle:

*Last:

**Maiden or Surname:

*City:

County:

*State or Country:

*Date of Birth:

/ /	*State or Country of Birth:

Race:

(mm/dd/yyyy)

*Number of this Marriage:

*Has Spouse 1 taken a Pre-Marital Class? YesNo

** Date Last Marriage Ended:

/ / (mm/dd/yyyy)

**How did Spouse 1's Last Marriage End?