Illinois Administrative Code
Title 77 - PUBLIC HEALTH
Part 500 - ILLINOIS VITAL RECORDS CODE
Appendix C - Marriage Application and Record
AFFIDAVIT OF CONSENT OF PARENT OR GUARDIAN FOR MARRIAGE OF MINOR
|
STATE OF ILLINOIS |
SS. |
|
COUNTY______________________ |
|
______________________________ AND ______________________________
BEING DULY SWORN, DEPOSES AND SAYS THAT THEY ARE THE PARENTS OR GUARDIAN OF_______________________, A MINOR, AND GIVE THEIR CONSENT TO THE MARRIAGE OF SAID MINOR TO___________________________________, AND AFFIANTS FURTHER SAY THAT THE SAID MINOR WAS BORN__________________, 19____.
|
SIGNATURE OF FATHER OR GUARDIAN |
___________________ |
|
SIGNATURE OF MOTHER OR GUARDIAN |
___________________ |
SUBSCRIBED AND SWORN TO BEFORE ME THIS ______ DAY OF ____________________________, 19______.
|
_________________________________________ SIGNATURE OF COUNTY CLERK OR NOTARY |
_____________________________________________________________
|
STATE OF ILLINOIS |
SS. |
|
COUNTY______________________ |
|
____________________________ AND _______________________________
BEING DULY SWORN, DEPOSES AND SAYS THAT THEY ARE THE PARENTS OR GUARDIAN OF_______________________, A MINOR, AND GIVE THEIR CONSENT TO THE MARRIAGE OF SAID MINOR TO_________________________________, AND AFFIANTS FURTHER SAY THAT THE SAID MINOR WAS BORN__________________, 19____.
|
SIGNATURE OF FATHER OR GUARDIAN |
___________________ |
|
SIGNATURE OF MOTHER OR GUARDIAN |
___________________ |
SUBSCRIBED AND SWORN TO BEFORE ME THIS ______ DAY OF ____________________________, 19______.
|
_________________________________________ SIGNATURE OF COUNTY CLERK OR NOTARY |
