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In which at least one applicant resides. If neither applicant is a Maine resident, return the application to any municipality. The License and Certificate of Marriage will be prepared from the information on this form. It is valid only for marriages performed in the State of Maine. GROOM SECTION 1a. FIRST NAME 2. AGE LAST BIRTHDAY 1b. MIDDLE NAME 3.GROOM S RESIDENCE - State 1c. LAST NAME 1d. JR., ETC. 4. FATHER S NAME (First, Middle Initial, Last) 6. MOTHER S NAME (First, Middle Init.

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