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Get CA Application for Confidential Marriage License 2009-2024

/DD/CCYY) 3. STATE/COUNTRY OF BIRTH 4. #PREV. MARRIAGES/SRDP 5A. LAST MARRIAGE/SRDP ENDED BY: 5B. DATE ENDED (MM/DD/CCYY)  DEATH  DISSO  ANNULMENT  TERM SRDP  N/A 6. ADDRESS 7. CITY 8. STATE/COUNTRY 9. ZIP CODE 10A. FULL BIRTH NAME OF FATHER/PARENT 10B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY) 11A. FULL BIRTH NAME OF MOTHER/PARENT 11B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY) 12B. MIDDLE 12C. CURRENT LAST  Groom  Bride SECOND PERSON DATA 12A. FIRST NA.

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