Marriage Intentions

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State of Maine

Department of Health and Human Services

Intention of Marriage Application (VS-2A) Please type or print with black ink Party A (check one:) □ Bride □ Groom □ Spouse Proposed Date of Marriage: (Parties under the age of 18 are not permitted to be married in the State of Maine.)

1. Current Name (First, Middle, Last, Suffix)

2. Name Prior to First Marriage (First, Middle, Last, Suffix)

3. Birthplace State         4. Birthplace Country          5. Date of Birth (mm/dd/yyyy)            6. Age     7. Sex/Gender:
                                                                                                                  □ Male   □ Female
                                                                                                                  □ Nonbinary X
8. Father/Parent Name Prior to First Marriage (First, Middle, Last, Suffix)                    9. Birthplace State 10. Country

11. Mother/Parent Name Prior to First Marriage (First, Middle, Last, Suffix) 12. Birthplace State                          13. Country

14. Party A Residence Address (Street number, name and/or designator)                           15. City/Town

16. County                              17. State                             18. Country                                  19. Zip Code

20. Party A Mailing Address (Street or PO) (Apt/Unit)                                           21. City/Town

22. County                              23. State                             24. Country                                  25. Zip Code

26. Party A Telephone Number (10 digits)                                      27. Party A E-mail Address (If applicable)

28. Party A Proposed New Name After this Marriage (First, Middle, Last, Suffix)                             29. Social Security Number*

30. Number of this Marriage: (First, Second, etc.)                       31. If Previously Married, Last Marriage Ended by:
                                                                               □ Death      □ Divorce         □ Annulment
32. Date Last Marriage Ended (mm/dd/yyyy)                 33. Name of Former Spouse (First, Middle, Last, Suffix)

34. Name and Location of Court or City/State and Country of Death

35. Is Party A registered with the State of Maine as a Domestic Partner? □ Yes □ No

36. First cousins are required by law to obtain a certificate of genetic counseling by a physician. Are you first cousins? □ Yes □ No Signed Certification ~ I hereby certify that the information above is correct to the best of my knowledge and belief and that I am free to marry under the laws of Maine. I understand this “intentions to marry” application is valid only for marriages performed in the State of Maine to obtain a marriage license. Signature of Party A Date Signed ► The above-named party has personally appeared before me and made oath to the truth and foregoing statement. Notaries, please do not use a notary seal, embosser or stamp on marriage intentions or marriage licenses. Signature of Notary Public or Filing Official Printed Name Date Signed ► My Term Expires City/Town County State

*Federal law requires the collection of Social Security numbers from applicants for a marriage license. (42 USC §666). The SSN is confidential information and may not be disclosed (1 M.R.S. §402 (3)(N). This document (the "State of Maine Intentions of Marriage" application) becomes a public record 50 years after the date on this intention to marry application (19-A M.R.S. §651). Because the SSN is confidential information that may not be disclosed, it must be deleted (redacted) from this document before it is open for public inspection after 50 years. The Social Security number (SSN) is retained by the State Agency and the municipal clerks responsible for the administration of the system of vital statistics.

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VS2-A Marriage Intentions 09/2025

State of Maine

Department of Health and Human Services

Intention of Marriage Application (VS-2A) Please type or print with black ink Party B (check one:) □ Bride □ Groom □ Spouse Proposed Date of Marriage: (Parties under the age of 18 are not permitted to be married in the State of Maine.)

37. Current Name (First, Middle, Last, Suffix)

38. Name Prior to First Marriage (First, Middle, Last, Suffix)

39. Birthplace State          40. Birthplace Country        41. Date of Birth (mm/dd/yyyy)             42. Age  43. Sex/Gender:
                                                                                                                    □ Male   □ Female
                                                                                                                    □ Nonbinary X
44. Father/Parent Name Prior to First Marriage (First, Middle, Last, Suffix)                    45. Birthplace State 46. Country

47. Mother/Parent Name Prior to First Marriage (First, Middle, Last, Suffix) 48. Birthplace State                          49. Country

50. Party B Residence Address (Street number, name and/or designator)                           51. City/Town

52. County                              53. State                             54. Country                                   55. Zip Code

56. Party B Mailing Address (Street or PO) (Apt/Unit)                                           57. City/Town

58. County                              59. State                             60. Country                                   61. Zip Code

62. Party B Telephone Number (10 digits)                                      63. Party B E-mail Address (If applicable)

64. Party B Proposed New Name After this Marriage (First, Middle, Last, Suffix)                             65. Social Security Number*

66. Number of this Marriage: (First, Second, etc.)                       67. If Previously Married, Last Marriage Ended by:
                                                                               □ Death      □ Divorce         □ Annulment
68. Date Last Marriage Ended (mm/dd/yyyy)                 69. Name of Former Spouse (First, Middle, Last, Suffix)

70. Name and Location of Court or City/State and Country of Death

71. Is Party B registered with the State of Maine as a Domestic Partner? □ Yes □ No

72. First cousins are required by law to obtain a certificate of genetic counseling by a physician. Are you first cousins? □ Yes □ No Signed Certification ~ I hereby certify that the information above is correct to the best of my knowledge and belief and that I am free to marry under the laws of Maine. I understand this “intentions to marry” application is valid only for marriages performed in the State of Maine to obtain a marriage license. Signature of Party B Date Signed ► The above-named party has personally appeared before me and made oath to the truth and foregoing statement. Notaries, please do not use a notary seal, embosser or stamp on marriage intentions or marriage licenses. Signature of Notary Public or Filing Official Printed Name Date Signed ► My Term Expires City/Town County State

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VS2-A Marriage Intentions 09/2025

State of Maine

Department of Health and Human Services

Intention of Marriage Application (VS-2A)

INSTRUCTIONS FOR PARTIES: Complete every item carefully. Please type or neatly print. BLACK ink is preferred. Check the boxes and sign the certification portion in the presence of a notary public or a municipal clerk. If the parties are Maine residents, file the completed marriage intentions with the municipality in which at least one party resides or the State Registrar of Vital Statistics. If neither party is a Maine resident, the parties may file the completed intentions in any municipality in the State of Maine or with the State Registrar of Vital Statistics.

Previously Married Parties Parties who have been previously married must present a certified copy of the death certificate of their deceased spouse or the record of their divorce or annulment before a marriage license can be issued. A record of divorce from another state or foreign country is evidence of divorce. If the record is not in English, it must be translated into English by a disinterested 3rd person at the parties' expense. A marriage contracted when either party fails to submit a certificate or certified copy of the divorce decree or annulment of the last marriage or the death certificate of the last spouse, or when either party makes false representations about previous marriages to obtain a marriage license, the marriage will become VOID.

Parties under 18 Years of Age Effective September 25, 2025, parties under the age of 18 are not permitted to be married in the State of Maine. Marriages of emancipated minors are treated as if the child is an adult of 18 years or older. Municipal clerks must be presented with court documents to ascertain the minor’s legal status before issuing a marriage license.

Related Parties (First Cousins) If parties are related as specified by Title 19-A §701 subsection 2, the parties must provide a signed certification from a physician stating that they have received genetic counseling.

Incarcerated Parties If either of the parties to the marriage is incarcerated in a state correctional facility (prison or jail), a marriage license may be issued (after filing the intentions) without the incarcerated party’s original signature on the marriage license. A letter from the facility in which the party is incarcerated must be provided to the issuing official to obtain the marriage license. The letter must be on the facility's letterhead and state that the party is incarcerated. The signature of the incarcerated party must be obtained on the marriage license at the time the ceremony is performed.

Imminent Death An authoritative request must be presented at the time marriage intentions are filed from a minister, clergyman, priest, rabbi, or attending physician stating that the death of either party is imminent. The authoritative request must be on the facility letterhead, name the patient, state that death is imminent, and state that the patient is conscious and coherent. The patient must make it known that it is their wish to be married and sign the letter in addition to the signature and printed name of the minister, clergyman, priest, rabbi, or attending physician who is declaring that the death is imminent.

Marriage License Once the marriage intentions have been filed, a marriage license may be issued and is valid for 90 days from the date the intentions were filed. Each party to the intended marriage must sign the marriage license in the presence of a municipal clerk, marriage officiant, or the State Registrar to acknowledge the certification statement on the marriage license. The parties are to provide the marriage license to the marriage officiant who will solemnize the marriage by performing a marriage ceremony, completing the marriage ceremony section on the marriage license, and obtaining the original signatures of two witnesses who must be physically present during the ceremony. The officiant or the parties must return the marriage license to the issuing authority that issued the marriage license within 15 working days after the ceremony was performed. Completed marriage licenses returned after 15 working days from the date the ceremony was performed will be marked as a late filing.

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VS2-A Marriage Intentions 09/2025

Source: marriage-intentions-fillable.pdf on durhammaine.gov. Text extracted with pdftotext; no wording has been corrected.