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Get CA Application for Confidential Marriage License - San Benito County 2015-2024

DD/CCYY) 14. STATE/COUNTRY OF BIRTH 15. # PREV. MARRIAGES/SRDP 16A. LAST MARRIAGE/SRDP ENDED BY: 16B. DATE ENDED (MM/DD/CCYY)  DEATH  DISSO  ANNULMENT  TERM SRDP  N/A 17. ADDRESS 18. CITY 19. STATE/COUNTRY 20. ZIP CODE 21A. FULL BIRTH NAME OF FATHER/PARENT 21B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY) 22A. FULL BIRTH NAME OF MOTHER/PARENT 22B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY) WE, THE UNDERSIGNED, CURRENTLY LIVING TOGETHER AS SPOUSES, DECLARE UNDER PE.

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