Marriage (Forms) Amendment Regulations 2013

Form 1
Notice of intended marriage

r 3(a)

Section 23(1), Marriage Act 1955

[Please print or write clearly.] [Important: One of the parties must deliver the notice personally to the Registrar of Marriages and make the required statutory declaration. Please produce evidence, if available, of the dissolution of the most recent marriage or civil union of each of the parties, if any.
At least 3 days’ notice of intended marriage is required]
 
        
To the Registrar of Marriages in      Notice No: 
    Full address of place where marriage is to be solemnised and any alternative address below 
Notice is given that the parties named below intend to marry at either      
         
  or at      
    Date or approximate date of marriage    
*A marriage licence is valid for 3 months only.*on     
  Full name of marriage celebrant
(not required if marriage to be performed by Registrar)
Denomination or organisation 
         
  by     
         

     Parties to marriage  
 Heading for copy of particulars and certificates/printouts for this marriage BrideBridegroomPartner BrideBridegroomPartner 
Current first or given name(s)
Current surname or family name
     
First or given name(s) at birth
(if different from above)
Surname or family name at birth
(if different from above)
     
 Sex     
Full date of birth     
Place of birth     
Usual occupation, profession, or job     
What was your last relationship (if any)?
If previously married or in a civil union:
 Never been married or in a civil unionMarriageCivil union Never been married or in a civil unionMarriageCivil union 
 (1) how did that relationship end? By dissolution/ divorce  Death of
spouse/ partner
 By dissolution/ divorce  Death of
spouse/ partner
 
 (2) when did that relationship end? [date] [date] 
Usual residential address in full, including—
• flat number (if applicable)
• street number and name
• suburb or rural locality
• city, town, or district
• country (if not New Zealand)
     
    Parents  
 MotherFather   MotherFather   
First or given name(s)
Surname or family name
     
Surname or family name at birth
(if different from above)
     
  MotherFatherOther parent MotherFatherOther parent 
First or given name(s)
Surname or family name
     
Surname or family name at birth
(if different from above)
     

  Statutory declaration [The portion of form below to be completed in front of the Registrar.]
I solemnly and sincerely declare— 1that the information provided in this notice is true; and
  2that I believe that the marriage is not prohibited by section 15 of the Marriage Act 1955; and
†Delete paragraph 3 if not applicable. †3that, [name] being under the age of 18 years, the consents required by law to the intended marriage have been given; and
  4that there is no lawful impediment to the intended marriage.
And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957.
Important
Section 15 of the Marriage Act 1955 referred to in the statutory declaration, and Schedule 2 of that Act setting out forbidden marriages, are printed on the back of this form.
 Declared at: [place, date]
   
Signature of party giving notice:
   
Print full name of party giving notice:
 
   
   
Signature of Registrar of Marriages:
   
Print full name of Registrar of Marriages: