Ill. Admin. Code tit. 77, pt. 500, app C - Marriage Application and Record

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AFFIDAVIT OF CONSENT OF PARENT OR GUARDIAN FOR MARRIAGE OF MINOR

STATE OF ILLINOIS	SS.
COUNTY______________________

______________________________ AND ______________________________

BEING DULY SWORN, DEPOSES AND SAYS THAT THEY ARE THE PARENTS OR GUARDIAN OF_______________________, A MINOR, AND GIVE THEIR CONSENT TO THE MARRIAGE OF SAID MINOR TO___________________________________, AND AFFIANTS FURTHER SAY THAT THE SAID MINOR WAS BORN__________________, 19____.

SIGNATURE OF FATHER OR GUARDIAN	___________________
SIGNATURE OF MOTHER OR GUARDIAN	___________________

SUBSCRIBED AND SWORN TO BEFORE ME THIS ______ DAY OF ____________________________, 19______.

_________________________________________ SIGNATURE OF COUNTY CLERK OR NOTARY

_____________________________________________________________

STATE OF ILLINOIS	SS.
COUNTY______________________

____________________________ AND _______________________________

BEING DULY SWORN, DEPOSES AND SAYS THAT THEY ARE THE PARENTS OR GUARDIAN OF_______________________, A MINOR, AND GIVE THEIR CONSENT TO THE MARRIAGE OF SAID MINOR TO_________________________________, AND AFFIANTS FURTHER SAY THAT THE SAID MINOR WAS BORN__________________, 19____.

SIGNATURE OF FATHER OR GUARDIAN	___________________
SIGNATURE OF MOTHER OR GUARDIAN	___________________

SUBSCRIBED AND SWORN TO BEFORE ME THIS ______ DAY OF ____________________________, 19______.

_________________________________________ SIGNATURE OF COUNTY CLERK OR NOTARY

Notes

Ill. Admin. Code tit. 77, pt. 500, app C

Added at 15 Ill. Reg. 11706, effective August 1, 1991