Spouse One First Name Middle Name Last Name Suffix (Jr, Sr, III,etc) Birthplace (State or Foreign Country) Sex Male Female Date of Birth (Month, Day, Year) Phone Number Education College Elementary School High School Years Residence (No. And Street) City or Town County State ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS BRITISH COLUMBIA CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING XX Supervision or Control by Guardian or Conservator Yes No Number of This Marriage 1 2 3 4 5 6 7 8 9 10 Number of Civil Unions 0 1 2 3 4 5 6 7 8 9 10 Last Relationship Was Marriage Civil Union Last Relationship Ended By Annulment Death Dissolution Marrying CU Partner Father\Parent Name (Last Name Prior To First Marriage) Father\Parent Birthplace (State or Foreign Country) Mother\Parent Name (Last Name Prior To First Marriage) Mother\Parent Birthplace (State or Foreign Country) Spouse Two First Name Middle Name Last Name Suffix (Jr, Sr, III,etc) Birthplace (State or Foreign Country) Sex Male Female Date of Birth (Month, Day, Year) Phone Number Education College Elementary School High School Years Residence (No. And Street) City or Town County State ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS BRITISH COLUMBIA CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING XX Supervision or Control by Guardian or Conservator Yes No Number of This Marriage 1 2 3 4 5 6 7 8 9 10 Number of Civil Unions 0 1 2 3 4 5 6 7 8 9 10 Last Relationship Was Marriage Civil Union Last Relationship Ended By Annulment Death Dissolution Marrying CU Partner Father\Parent Name (Last Name Prior To First Marriage) Father\Parent Birthplace (State or Foreign Country) Mother\Parent Name (Last Name Prior To First Marriage) Mother\Parent Birthplace (State or Foreign Country)
