Government of Ontario: Ministry of Government and Consumer 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
DAY
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
DAY
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 (DD/MM/YYYY)
DAY
MONTH
YEAR

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

I DECLARE THAT THE ABOVE INFORMATION IS CORRECT:
SIGNATURE OF JOINT APPLICANT
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: The Deputy Registrar General, P.O. Box 4600 Thunder Bay ON P7B 6L8. Telephone 1 800 461-2156 or 416 325-8305.

11018 (2008/04)

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

MARRIAGE LICENCE APPLICATION Marriage Act - Form 3

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

MARRIAGE LICENCE APPLICATION
Marriage Act - Form 3