Sample Forms

Use with priest

 

First Name:.

Middle Name:

Current Last Name:

Maiden Name:

Address:

City:.

State:

Zip Code:

Home Phone: (_ DateofBirth:_

Work:(.
City & State of Birth:.

Have you ever been baptized? YES  NO If so, in which religion were you baptized:.
What religion do you currently practice?	
Which Church do you attend:	
City of Church you attend:	
Respondent

First Name:

Middle Name:

Current Last Name:

Maiden Name:

Address:

City:.

State:

Zip Code:

Home Phone:(_ Date of Birth:

Work:(_
City & State of Birth:.

Has s/he ever been baptized? YES  NO If so, in which religion was s/he baptized:.
What religion does s/he currently practice?.

Marriage
When did you first meet the Respondent (approximate month & year):.
When were you engaged (approximate month & year):	
Date of Marriage:	
City and State of Marriage:	
Place of marriage (church, chapel, courthouse, etc):.
Name of Church:	
Was this a validation ("blessing") of a civil marriage? YES NO
Date of Validation:	
Parish of Validation:
City and State of Church:.
Number of Previous Marriages by Petitioner:.
Number of Previous Marriages by Respondent:.
Petitioner's age at marriage:	       Respondent's age at marriage:
Number of Children:	
Divorce
Date of Final Separation:.
Date of Final Decree of Divorce:
Number of Later Marriages by Petitioner:.
Number of Later Marriages by Respondent:.
In regards to this marriage, have you petitioned another diocesan tribunal for an ecclesiastical annulment? YES NO
If so, when:	
Where:	_^___	

Present Marital Status of the Petitioner
Are you currently engaged? YES NO
Are you currently remarried? YES NO
Please complete the following information regarding your Present/Intended spouse:
First Name:	 Middle Name(s):	
Maiden Name:	     Current Last Name:	
Has your present/intended spouse been baptized? YES NO
If so, in which religion?	
Has your present/intended spouse been married before? YES NO
If so, how many times?	
Is the ex-spouse of your present/intended spouse deceased? YES NO
Counseling
Did you ever seek professional counseling for the difficulties you experienced before, during, or after this Marriage: YES NO
If yes, please give the specific months and years:	
Please give the name and address of the therapist or counseling center:

(Witnesses (please include as many as desired- minimum of 4 - use a separate sheet if needed)

Father's Name:	
Address:	
Citv/State/Zip:		
Phone Number:		
Mother's Name:	
Address:	
Citv/State/Zip:		
Phone number:		
Witnesses:	(Relationship):	
1. Name:	
	
Address:		
Citv/State/Zip:		
Phone number:		
2. Name:	("Relationship):	
Address:		
Citv/State/Zip:		
Phone number:		
3. Name:	(Relationship):	
Address:		
Citv/State/Zip:		
Phone number:		
4. Name:	(Relationship):	
Address:		
Citv/State/Zip:		
Phone number: