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Y/TOWN/LOCATION BIRTHSTATE (IF NOT USA GIVE COUNTRY) INSIDE CITY LIMITS Yes No COUNTY STATE FATHER S NAME (FIRST/LAST) BIRTHSTATE (IF NOT USA GIVE COUNTRY) MOTHER S MAIDEN NAME (FIRST/LAST) BIRTHSTATE (IF NOT USA GIVE COUNTRY) BRIDE BRIDE'S NAME FIRST MIDDLE LAST MAIDEN NAME CURRRENT RESIDENCE ADDRESS (NUMBER AND STREET) DATE OF BIRTH (MO/DAY/YR) BIRTHSTATE (IF NOT USA GIVE COUNTRY) CITY/TOWN/LOCATION INSIDE CITY LIMITS COUNTY Yes No STATE FATH.

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  • Applicants
  • BRIDES
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