Solicitante 1 Primer Nombre Segundo Nombre Apellido(s) Titulo Jr Sr I II III IV V Apellido antes de primero matrimonio (si aplica) Direccion Ciudad Estado AFGHANISTAN ALABAMA ALAND ISLANDS ALASKA ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA & BARBUDA ARGENTINA ARIZONA ARKANSAS ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA BOTSWANA BRAZIL BRITISH VIRGIN ISLANDS BRUNEI DARUSSALAM BULGARIA BURKINA FAXO BURUNDI CALIFORNIA CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS ISLANDS COLORADO COLUMBIA COMOROS CONGO CONNECTICUT COOK ISLANDS COSTA RICA CROATIA CUBA CYPRUS CZECH REPUBLIC DELAWARE DEMOCRATIC REPUBLIC OF CONGO DENMARK DISTRICT OF COLUMBIA DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS FAROE ISLANDS FEDERATED STATES OF MICRONESIA FIJI FINLAND FLORIDA FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GAHON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HAWAII HONDURAS HONG KONG HUNGARY ICELAND IDAHO ILLINOIS INDIA INDIANA INDONESIA IOWA IRAN IRAQ IRELAND ISLE OF MAN ISRAEL ITALY Jamaica Japan JERSEY JORDAN KANSAS KAZAKHSTAN KENTUCKY KENYA KIRIBATI KOREA KOREA REPUBLIC OF KUWAIT KYRGYSTAN LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LOUISIANA LUXEMBOURG MACEDONIA MADAGASCAR MAINE MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARSHALL ISLANDS MARTINIQUE MARYLAND MASSACHUSETTS MAURITANIA MAURITIUS MAYOTTE MEXICO MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONACO MONGOLIA MONTANA MONTENEGRO MONTSERRATT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEBRASKA NEPAL NETHERLANDS NEVADA NEW CALEDONIA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS NORWAY OHIO OKLAHOMA OMAN OREGON PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PENNSYLVANIA PERU PHILLIPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REPUBLIC OF MOLDOVA REUNION RHODE ISLAND ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHALEMY SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN SAINT PIERRE AND MIQUELON SAINT VINCENT AND GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN SLOVENIA SLOVOKIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH CAROLINA SOUTH DAKOTA SOUTH GEORGIA SOUTH SANDWICH ISLANDS SPAIN SRI LANKA STATE OF PALESTINE SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TENNESSEE TEXAS THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD & TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS & CAICOS ISLANDS TUVALU UGANDA UKRAINE United Arab Emirates United Kingdom UNITED REPUBLIC OF TANZANIA URUGUAY US VIRGIN ISLANDS UTAH UZBEKISTAN VANUATU VATICAN CITY VENEZUELA VERMONT VIETNAM VIRGIN ISLANDS VIRGINIA WALLIS & FUTUNA WASHINGTON WEST VIRGINIA WESTERN SAHARA WISCONSIN WYOMING YEMEN ZAMBIA ZIMBABWE Condado Dentro de los limites de la Cuidad Si No Lugar de nacimiento (Condado y Estado o Pais) Fecha de Nacimiento (mm/dd/aaaa) Género (Opcional) Hombre Mujer Raza (Opcional) Educación Colegio/Universidad Escuela Primaria Escuela Secundaria/Preparatoria Años de educación Numero de este Matrimonio 1 2 3 4 5 6 7 8 9 10 Ultimo Matrimonio Termino en. Anulación Fallecimiento Dissolution Divorcio Fecha que Termino el Matrimonio Nombre de Padre/Madre al nacer Estado de Nacimiento Direccion (Si vive) Nombre de Padre/Madre al nacer Estado de Nacimiento Direccion (Si vive) Solicitante 2 Primer Nombre Segundo Nombre Apellido(s) Titulo Jr Sr I II III IV V Apellido antes de primero matrimonio (si aplica) Direccion Ciudad Estado AFGHANISTAN ALABAMA ALAND ISLANDS ALASKA ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA & BARBUDA ARGENTINA ARIZONA ARKANSAS ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA BOTSWANA BRAZIL BRITISH VIRGIN ISLANDS BRUNEI DARUSSALAM BULGARIA BURKINA FAXO BURUNDI CALIFORNIA CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS ISLANDS COLORADO COLUMBIA COMOROS CONGO CONNECTICUT COOK ISLANDS COSTA RICA CROATIA CUBA CYPRUS CZECH REPUBLIC DELAWARE DEMOCRATIC REPUBLIC OF CONGO DENMARK DISTRICT OF COLUMBIA DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS FAROE ISLANDS FEDERATED STATES OF MICRONESIA FIJI FINLAND FLORIDA FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GAHON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HAWAII HONDURAS HONG KONG HUNGARY ICELAND IDAHO ILLINOIS INDIA INDIANA INDONESIA IOWA IRAN IRAQ IRELAND ISLE OF MAN ISRAEL ITALY Jamaica Japan JERSEY JORDAN KANSAS KAZAKHSTAN KENTUCKY KENYA KIRIBATI KOREA KOREA REPUBLIC OF KUWAIT KYRGYSTAN LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LOUISIANA LUXEMBOURG MACEDONIA MADAGASCAR MAINE MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARSHALL ISLANDS MARTINIQUE MARYLAND MASSACHUSETTS MAURITANIA MAURITIUS MAYOTTE MEXICO MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONACO MONGOLIA MONTANA MONTENEGRO MONTSERRATT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEBRASKA NEPAL NETHERLANDS NEVADA NEW CALEDONIA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS NORWAY OHIO OKLAHOMA OMAN OREGON PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PENNSYLVANIA PERU PHILLIPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REPUBLIC OF MOLDOVA REUNION RHODE ISLAND ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHALEMY SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN SAINT PIERRE AND MIQUELON SAINT VINCENT AND GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN SLOVENIA SLOVOKIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH CAROLINA SOUTH DAKOTA SOUTH GEORGIA SOUTH SANDWICH ISLANDS SPAIN SRI LANKA STATE OF PALESTINE SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TENNESSEE TEXAS THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD & TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS & CAICOS ISLANDS TUVALU UGANDA UKRAINE United Arab Emirates United Kingdom UNITED REPUBLIC OF TANZANIA URUGUAY US VIRGIN ISLANDS UTAH UZBEKISTAN VANUATU VATICAN CITY VENEZUELA VERMONT VIETNAM VIRGIN ISLANDS VIRGINIA WALLIS & FUTUNA WASHINGTON WEST VIRGINIA WESTERN SAHARA WISCONSIN WYOMING YEMEN ZAMBIA ZIMBABWE Condado Dentro de los limites de la Cuidad Si No Lugar de nacimiento (Condado y Estado o Pais) Fecha de Nacimiento (mm/dd/aaaa) Género (Opcional) Hombre Mujer Raza (Opcional) Educación Colegio/Universidad Escuela Primaria Escuela Secundaria/Preparatoria Años de educación Numero de este Matrimonio 1 2 3 4 5 6 7 8 9 10 Ultimo Matrimonio Termino en. Anulación Fallecimiento Dissolution Divorcio Fecha que Termino el Matrimonio Nombre de Padre/Madre al nacer Estado de Nacimiento Direccion (Si vive) Nombre de Padre/Madre al nacer Estado de Nacimiento Direccion (Si vive)
