Town of Plainville Marriage License Kiosk
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Cindy Arena
Town Clerk
Town of Plainville, CT
Spouse1
First Name
Middle Name
Last Name
Suffix
Sex
Male
Female
DOB (MM/DD/YYYY)
Age
Birth Place (State or Country)
Social Security #
Residence (No. and Street Name)
City or Town
County
State
Zip
Phone#
Supervision or Control by Guardian or Conservator
Yes:
No:
Father's Name
Father's BirthPlace
Mother's Maiden Name
Mother's BirthPlace
This Marriage#
1
2
3
4
5
6
7
8
9
10
Number of Civil Unions
0
1
2
3
4
5
6
7
8
9
10
Last Relationship
Marriage:
Civil:
Last Marriage Ended In
Death
Divorce
Annul
Previous Civil Union Did Not End. Marrying Civil Union Partner
Education Years Completed:
Grades 1-8
0
1
2
3
4
5
6
7
8
Grades 9-12
0
9
10
11
12
College 1-5+
0
1
2
3
4
5
5+
Spouse2
First Name
Middle Name
Last Name
Suffix
Sex
Male
Female
DOB (MM/DD/YYYY)
Age
Birth Place (State or Country)
Social Security #
Residence (No. and Street Name)
City or Town
County
State
Zip
Phone#
Supervision or Control by Guardian or Conservator
Yes:
No:
Father's Name
Father's BirthPlace
Mother's Maiden Name (First and Maiden Last Name)
Mother's BirthPlace
This Marriage#
1
2
3
4
5
6
7
8
9
10
Number of Civil Unions
0
1
2
3
4
5
6
7
8
9
10
Last Relationship
Marriage:
Civil:
Last Marriage Ended In
Death
Divorce
Annul
Previous Civil Union Did Not End. Marrying Civil Union Partner
Education Years Completed:
Grades 1-8
0
1
2
3
4
5
6
7
8
Grades 9-12
0
9
10
11
12
College 1-5+
0
1
2
3
4
5
5+
Other Information
OFFICIATOR’S NAME & PHONE # (IF KNOWN):
EXPECTED DATE OF MARRIAGE
YOUR PHONE NUMBER
EMAIL
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