World Marriage Certificate

APPLICATION FORM FOR WSA'S WORLD MARRIAGE CERTIFICATE

(Only for persons 18 years or older)

Issued by WORLD SERVICE AUTHORITY WASHINGTON, D.C. 20005

Men and women of full age, without any limitations due to race, nationality or religion, have the right to marry and to found a family. They are entitled to equal rights as to marriage and at its dissolution." "Marriage shall be entered into only with the free and full consent of the intending spouses.

Article 16, 1 & 2, Universal Declaration of Human Rights

In conformity with the above article, we, the undersigned, do hereby declare our mutual consent as partners in marriage. We also state that we are registered citizens of the World Government of World Citizens. (If not yet registered, we have submitted our registration forms with this application. To obtain World Citizen registration forms, click here World Citizen Registration.)

(Please print or type)

Name (First, Middle, Last):_____________________________________

Date of Birth(Day, Month, Year):_______________________

Place of Birth:________________________________________


I swear and certify that the information above is true and correct.

DATA CONSENT: By signing below, the applicant gives explicit consent (opts in) to provide and share their personal information and data.

WC Reg. #_______________________

Signature________________________________


Address:

Street and number______________________________

City or Town___________________________________

State/Province/Region:_________________________

Postal Code:______________

Country:__________________



Name (First, Middle, Last):_____________________________________

Date of Birth(Day, Month, Year):_______________________

Place of Birth:________________________________________


I swear and certify that the information above is true and correct.

DATA CONSENT: By signing below, the applicant gives explicit consent (opts in) to provide and share their personal information and data.

WC Reg. #_______________________

Signature________________________________


Address:

Street and number______________________________

City or Town___________________________________

State/Province/Region:______________________________

Postal Code:______________

Country:__________________


CERTIFICATION OF SIGNATURES

On this ________day of_____________20_______, before me

came___________________________________________________

and____________________________________________________,

known to me and known by me to be the persons who executed the foregoing application, and they thereupon duly acknowledged to me that they executed the same. (Note: if no certifying official is available, enclose photocopies of identity papers.)

_____________________________ Signature and Seal, Notary/Certifying Official

Issuing fee: US$75 plus $10 for shipping & handling - Please make out international check or money order in US Dollars to WORLD SERVICE AUTHORITY. You may also pay by credit card--please see form at the bottom of the application for the World Passport. (Click here to go to the credit card form.) Contact the WSA for alternative fee payment options. Send fee with completed form to:

World Service Authority *
5 Thomas Circle, NW *
Washington, D.C. 20005 *
Tel: (202) 638-2662 *
Fax: (202) 638-0638

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