DATA SOURCE:

Your relationship to husband/wife:

WIFE'S PARENTS

Mother

Father

HUSBAND'S PARENTS

WIFE

Marr. Age:

Burial Date:

Death Date:

Surname:

Given Names:

HUSBAND

Marriage Date:

Marriage Place:

MARRIAGE DATA

I will provide proxies for sealing.

Send all names to my family file at the _____________ Temple.

[ ] Option 2--FAMILY FILE



Send all names to any temple and assign proxies for sealing.

[ ] Option 1--TEMPLE FILE



For the couple submitted on this form, mark the box for one of the following options:

Home Phone:

Stake/Mission:

Stake Number:

Name and Address of submitter:

MARRIAGE ENTRY (for sealing wife to husband)