Title 19-A; Section 651(2)
Application Process

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RECORD OF SOCIAL SECURITY NUMBERS PER ABOVE LAW
When the application for marriage license is submitted, the applicant(s) shall provide the clerk with the social security numbers of the parties.
_________________ Groom Social Security Number
_________________ Bride Social Security Number
_________________ Date

I hereby certify that the above informtion is true and correct to the best of my knowledge.
_________________ Groom Signature
_________________ Bride Signature
I hereby certify that I will record the above social security numbers as required by the law and that they will remain confidential and not open for public inspection.
_________________ Town Clerk
_________________ Date