Government of Ontario: Ministry of Consumer and Business Services
Office of the Registrar General

MARRIAGE LICENCE APPLICATION Marriage Act - Form 3

Marriage Licence No.

APPLICANT

LAST NAME
FIRST AND MIDDLE NAMES

MARITAL STATUS

NEVER MARRIED
WIDOWED
DIVORCED

IF DIVORCED IN CANADA, please provide the court file number

COURT FILE NUMBER
CITY DIVORCE GRANTED IN

RELIGIOUS DENOMINATION

AGE AND DATE OF BIRTH
AGE

DATE OF BIRTH
DATE
MONTH
YEAR

PLACE OF BIRTH

PROVINCE (IF OUTSIDE CANADA, COUNTRY)

FATHER'S NAME (Last, First)

LAST NAME
FIRST (NAMES)

MOTHER'S MAIDEN NAME (Last name before marriage, First)

LAST NAME
FIRST (NAMES)

FATHER'S PLACE OF BIRTH

PROVINCE (IF OUTSIDE CANADA, COUNTRY)

MOTHER'S PLACE OF BIRTH

PROVINCE (IF OUTSIDE CANADA, COUNTRY)

PRESENT RESIDENCE OR POSTAL ADDRESS

STREET NAME AND NUMBER
APT
CITY OR TOWN
PROVINCE
POSTAL CODE
TELEPHONE NUMBER

PERMANENT HOME ADDRESS IF DIFFERENT FROM ABOVE

STREET NAME AND NUMBER
APT
CITY OR TOWN
PROVINCE
POSTAL CODE
TELEPHONE NUMBER

JOINT APPLICANT

LAST NAME
FIRST AND MIDDLE NAMES

MARITAL STATUS

NEVER MARRIED
WIDOWED
DIVORCED

IF DIVORCED IN CANADA, please provide the court file number

COURT FILE NUMBER
CITY DIVORCE GRANTED IN

RELIGIOUS DENOMINATION

AGE AND DATE OF BIRTH
AGE

DATE OF BIRTH
DATE
MONTH
YEAR

PLACE OF BIRTH

PROVINCE (IF OUTSIDE CANADA, COUNTRY)

FATHER'S NAME (Last, First)

LAST NAME
FIRST (NAMES)

MOTHER'S MAIDEN NAME (Last name before marriage, First)

LAST NAME
FIRST (NAMES)

FATHER'S PLACE OF BIRTH

PROVINCE (IF OUTSIDE CANADA, COUNTRY)

MOTHER'S PLACE OF BIRTH

PROVINCE (IF OUTSIDE CANADA, COUNTRY)

PRESENT RESIDENCE OR POSTAL ADDRESS

STREET NAME AND NUMBER
APT
CITY OR TOWN
PROVINCE
POSTAL CODE
TELEPHONE NUMBER

PERMANENT HOME ADDRESS IF DIFFERENT FROM ABOVE

STREET NAME AND NUMBER
APT
CITY OR TOWN
PROVINCE
POSTAL CODE
TELEPHONE NUMBER

INTENDED PLACE OF MARRIAGE
CITY, TOWN, VILLAGE
COUNTY OR DISTRICT
INTENDED DATE OF MARRIAGE

I DECLARE THAT THE ABOVE INFORMATION IS CORRECT:
SIGNATURE OF APPLICANT

DATE

I DECLARE THAT THE ABOVE INFORMATION IS CORRECT:
SIGNATURE OF BRIDE

DATE

Personal Information contained on this form is collected under the authority of the Marriage Act, R.S.O. 1990, c. M. 3 and will be used to determine whether to issue the marriage licence, to register and record the marriage, provide certified copies, extracts, certificates, search notices, photocopies and for statistical, research, medical, law enforcement, adoption and adoption disclosure purposes. Questions about this collection should be directed to:
Deputy Registrar General
P.O. Box 4600 189 Red River Road Thunder Bay ON P7B 6L8
1-800-461-2156 or (416) 325-8305

11018 (03/04)

Government of Ontario: Ministry of Consumer and Business Services Office of the Registrar General

MARRIAGE LICENCE APPLICATION Marriage Act - Form 3

Government of Ontario: Ministry of Consumer and Business Services
Office of the Registrar General