Please Complete This Form in It’s Entirety

LICENSE APPLICATION

Thank you for considering Wedding Proxy by 406 Proxy, LLC of Lewistown, Montana. In order to speed up the process of your application, please look through the form to ensure you have all information readily available to you. Among other details within the form, you will need to submit proof of identification that accompanies this form to the Clerk of Courts. No information is saved or stored on our servers.

If you have a question about the form please message the WeddingProxy.com Team by using the chat box, contact page or call 406.717.5858.

Wedding License Questionnaire

All fields are mandatory and the form will not progress without an answer.

"*" indicates required fields

APPLICANT NAME

First Name*

Middle Name*

Last Name*

SSN*

Phone*

Email*

Date of Birth*

Age*

Race*

Gender*

Birthplace: City*

Birthplace: County*

Birthplace: State*

Birthplace: Country*

YOUR PHYSICAL ADDRESS:

What is your stateside address? For non US citizens (foreign nationals), what is your current address? No APO to be used for residence information.

Address*

Address 2

City*

County*

State/Province*

ZIP/Postal Code*

Country*

YOUR EDUCATION - Please specify highest grade completed

Education*

PREVIOUS MARRIAGE IF APPLICABLE

406 Proxy will need proof of divorce of most recent prior marriage. Please submit image or pdf of most recent divorce document.

Number of this Marriage*

Previous Marriage Terminated By:*

Your Maiden Last Name*

Name of Former Spouse*

Place of Death or Dissolution:*

406 Proxy will need death certificate of former spouse of prior marriage. Please submit an image or pdf of dated death certificate.

Date of Death*

Upload Death Certificate Here

Accepted file types: jpg, png, pdf, Max. file size: 512 MB.

Your divorce decree must show the following information:

Date of Divorce
Location of Court
Names of parties
Judge signature

Date of Dissolution:*

Upload Divorce Papers Here

Accepted file types: jpg, png, pdf, Max. file size: 512 MB.

YOUR FATHER'S INFORMATION - You will need to list where your father was born (City, State, Country) and where he currently lives. If details not known please remark: "UNKNOWN"

FATHER'S NAME*

What is your Father's full name, including middle name?

First Full Middle Last

Birthplace City*

Father's City of Birth

Birthplace State | Province*

Father born in what State or Province?

Birthplace Country*

Father born In what Country?

Current City*

Father's current city

Current State*

Father's current State/Province

Current Country*

Father's current Country

YOUR MOTHER'S INFORMATION - You will need to list where your mother was born (City, State, Country) and where she currently lives. If details not known please remark: "UNKNOWN"

MOTHER'S MAIDEN NAME*

WHAT WAS YOUR MOTHER'S NAME BEFORE SHE WAS MARRIED?

First Full Middle Maiden Surname

Birthplace City*

Mother born in what City?

Birthplace State | Province*

Mother born in what State or Province?

Birthplace Country*

Mother born in what Country?

Current City*

Mother's current city

Current State*

Mother's current State/Province

Current Country*

Mother's current Country

ADDITIONAL QUESTIONS

Are the Parties Related?*

Are you related to your fiance? Cousins, 1st cousins, 2nd cousins, etc. If so please mark YES.

Yes

Explain Relationship*

Prior Application Rejected?*

Have you ever been denied a Montana wedding license? If so, please mark YES

Yes

Why Rejected?*

WHERE SHOULD THE GOLD SEAL PARCHMENT BE SENT?

Please confer with the other Applicant. Only one (1) original will be sent as there is only one original.

Name*

Street Address*

City*

State/Province*

Zip/Postal Code*

Country*

UPLOAD YOUR PHOTO ID

Please upload a photo of your identification (example: driver license). To provide proof of active duty military status using a copy of your orders (image or PDF).
Any image or PDF submitted, along with this application will be used to confirm your legal status to be allowed to marry as an active duty military member under Montana law. This application and all images/pdf uploaded are not stored. and important details are encrypted on submission.

YOUR PHOTO ID*

Accepted file types: jpg, png, pdf, Max. file size: 512 MB.

IMAGE or PDF of YOUR ORDERS*

Accepted file types: jpg, png, pdf, Max. file size: 512 MB.

Remarks | Comments

Please use this space to let us know if there is anything in the form you could not complete properly and why. If you have a question please send a message or contact us at 406.717.5858.

Signed on This Date:*

Please Complete This Form in It’s Entirety

LICENSE APPLICATION

Wedding License Questionnaire

APPLICANT NAME

YOUR PHYSICAL ADDRESS:

YOUR EDUCATION - Please specify highest grade completed

PREVIOUS MARRIAGE IF APPLICABLE

YOUR FATHER'S INFORMATION - You will need to list where your father was born (City, State, Country) and where he currently lives. If details not known please remark: "UNKNOWN"

YOUR MOTHER'S INFORMATION - You will need to list where your mother was born (City, State, Country) and where she currently lives. If details not known please remark: "UNKNOWN"

ADDITIONAL QUESTIONS

WHERE SHOULD THE GOLD SEAL PARCHMENT BE SENT?

UPLOAD YOUR PHOTO ID

Before you press SUBMIT, please double check to be sure all dates are correct, information is completed and spelling is accurate