ࡱ> \^[` -bjbjss 4D$,$0p f!!!!!".#DQ/S/S/S/S/S/S/$0h 3w/E%!!%%w/!!/&&&% !!Q/&%Q/&&:+,,!d 1&%+ U,/00+R3 &3,3,8r#Z#@& $4@$r#r#r#w/w/& r#r#r#0%%%%$$$  $$$$$$ SD Department of Health 600 E Capitol Avenue Pierre, SD 57501-2536This is a legal document . Complete in ink or type and do not alter.PARENTAL CONSENT FORM If either applicant for a marriage license is between the age of sixteen and eighteen, that applicant shall submit to the Register of Deeds a notarized statement of consent to marry from one parent or legal guardian of the applicant SDCL 25-1-9. 1. Applicant Information:Groom: FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      First MiddleLast Suffix (Jr. II, etc.)  Is applicant between 16 and 18 years old?  FORMCHECKBOX  Yes If yes, bride s Parent/Legal guardian must sign below FORMCHECKBOX  No Bride: FORMTEXT       FORMTEXT       FORMTEXT      First Middle Last  Is applicant between 16 and 18 years old?  FORMCHECKBOX  Yes If yes, bride s Parent/Legal guardian must sign below FORMCHECKBOX  No 2. Parent/Legal Guardian Information: I am the Parent/Legal Guardian of the above named groom, and am authorized to consent to a marriage on behalf of my minor child pursuant to SDCL 25-1-9. I hereby consent to him marrying his intended bride.  FORMTEXT    $ & ( 2 4 6 8 L N P Z \ ^ ` t v x < > Z \ ^     $ jhkVUjhkVUh!hY.CJjhkVUjhkVUjhkVUjhY.UmHnHuj6hkVUjhY.UhZh!hZCJaJh!hY.CJaJhY.//E` gdY.$a$gdY.Skd$$Ifl0h`' t'644 la $$Ifa$gdY. $IfgdY. - ;ykd$$Ifl\~ hR<'    t644 la $IfgdY.@kd$$Ifl<'' t644 la  6 ^ |ykd$$Ifl\~ hR<'    t644 la $IfgdY. |||| $IfgdY.ykd$$Ifl\~ hR<'     t644 la : < w9w>kdJ$$Ifl<'' t644 la $IfgdY.gdY.ykd$$Ifl\~ hR<'     t644 la    " zugdY.>kd $$Ifl<'' t644 la $IfgdY.>kd5$$Ifl<'' t644 la" $ L t Nfkdo $$IflF <'8 8 8  t6    44 la $IfgdY.@kd$$Ifl<'' t644 la$ & : < > H J L N b d f p r t v & ( D F H &'( ( ((($(󚑈}{Uj hkVUh!hZCJ h!hZCJh!hZCJaJj hZUj hZUh!hZCJjhkVUjhkVUjhZUmHnHujhkVUhZjhZU0 $ & L>kd $$Ifl<'' t644 la $IfgdkVgdY.fkd $$IflF <'8 8 8  t6    44 la &'(6(^(zuppppggg $IfgdZgdZgdY.>kdy $$Ifl<'' t644 la $IfgdkV>kd $$Ifl<'' t644 la       FORMTEXT       FORMTEXT      Name RelationDate  Signature  I am the Parent/Legal Guardian of the above named bride, and am authorized to consent to a marriage on behalf of my minor child pursuant to SDCL 25-1-9. I hereby consent to her marrying her intended groom.  FORMTEXT       FORMTEXT       FORMTEXT      Name RelationDate  Signature  Subscribed and sworn to before me this  FORMTEXT      day of FORMTEXT      , 20 FORMTEXT       SEALSignature of Notary PublicDate My Commission expires FORMTEXT       Note: A Legal Guardian must attach or provide a certified copy of the court order appointing the Legal Guardian. 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