{"data":{"id":"us-la/rs-9-223","jurisdiction":"us-la","citation":"RS 9:223","heading":"Form","body":"A. An application for a marriage license shall be made on a form provided by Subsection B of this Section.\nB. The application form shall be as follows:\nApplication for Marriage\n__________________(Parish), State of Louisiana\nDate of Application:\nHour of Application:\nGROOM\nLast Name of Groom\nFirst Name of Groom\nMiddle/Second Name of Groom\nAddress\nIs residence inside city limits?\n☐ Yes ☐ No\nParish/County\nState\nRace\nDate of Birth (month-day-year)\nState of Birth\nFather's Name\nState of Birth\nMother's Maiden Name\nState of Birth\nBRIDE\nLast Name of Bride\nFirst Name of Bride\nMiddle/Second Name of Bride\nMaiden Name of Bride\nAddress\nIs residence inside city limits?\n☐ Yes ☐ No\nParish/County\nState\nRace\nDate of Birth (month-day-year)\nState of Birth\nFather's Name\nState of Birth\nMother's Maiden Name\nState of Birth\nCovenant Marriage\nCovenant Marriage☐ Yes☐ NoIf yes, complete the following:\nWe, ___________________________ and _____________________________\ndo hereby declare our intent to contract a Covenant Marriage and, accordingly, have executed a declaration of intent attached hereto.\nGroom\nHas the groom been formerly married?_________\nHow many times?________\nAre you divorced ________?\nBride\nHas the bride been formerly married?_________\nHow many times?________\nAre you divorced ________?\nSSN\nGrooms's Social Security Number\nBride's Social Security Number\nI ___________________________ (print name of groom) do swear or affirm that the information contained in this application for marriage is true and correct. I further swear or affirm that this is my ______ (1st, 2nd, etc. number) marriage but that I am not currently married to anyone else, and that I am free to marry under the laws of the state of Louisiana. I further understand and acknowledge that giving any false information or false statement in this application of marriage shall constitute the crime of filing a false public record in violation of the Louisiana Criminal Code (R.S. 14:133).\n____________________________\nSignature of Groom\nSworn to and subscribed before me this ________ day of __________________, 20___.\n___________________ Notary Public/Deputy Clerk/Deputy Registrar\nI ___________________________ (print name of bride) do swear or affirm that the information contained in this application for marriage is true and correct. I further swear or affirm that this is my ______ (1st, 2nd, etc. number) marriage but that I am not currently married to anyone else, and that I am free to marry under the laws of the state of Louisiana. I further understand and acknowledge that giving any false information or false statement in this application of marriage shall constitute the crime of filing a false public record in violation of the Louisiana Criminal Code (R.S. 14:133).\n____________________________\nSignature of Bride\nSworn to and subscribed before me this ________ day of __________________, 20___.\n___________________ Notary Public/Deputy Clerk/Deputy Registrar","path":["TITLE 9. CIVIL CODE-ANCILLARIES"],"source_url":"https://www.legis.la.gov/legis/Law.aspx?d=106994","current_through":"2025 First Extraordinary Session","vintage":"","retrieved_at":"2026-09-14T04:49:15Z","sha256":"191be96d9035d739633a28c915a985726277930972077494044b9ca762cd2926","source_id":"us-la","stale":false,"prev":"us-la/rs-9-222","next":"us-la/rs-9-224"},"notice":"GroundRules: Original legal text. Not legal advice."}