MUST BE ACCOMPANIED BY A NEVADA COURT ORDER OR LEGAL GUARDIAN CONSENT FOR OF A

MUST BE ACCOMPANIED BY CERTIFIED COPY OF NEVADA DISTRICT COURT ORDER

______, being duly sworn, affirms, deposes and states as follows: Print Name of Parent or Guardian

1. This Consent to Marriage of a Minor Child is made pursuant to the provisions of NRS 122.025 for the purpose of obtaining proper consent for the minor child’s Application for in the County of Washoe, State of Nevada.

2. The undersigned parent(s) or legal guardian(s) hereby knowingly and voluntarily consent(s) to the marriage of my/our child, who is 17 years of age, to the prospective spouse, both of whom are named below.

3. I/We hereby certify and affirm that I/we am/are the (parent, father, mother, or guardian), of (insert name of minor), the “Minor”, whose birth date is and is currently 17 years of age.

4. I/We hereby consent to the marriage of (insert name of minor) to (insert name of future spouse), and further consent to the issuance of a marriage license for said marriage by the Washoe County Clerk.

5. Check the statement for the applicable provision below:

____ I/We hereby affirm that I/we am/are the parent(s) of the Minor listed above.

____ I/We hereby affirm that while I/we am/are not a parent of the Minor, I/we am/are the legal guardian(s) of said Minor, as evidenced by the certified copy of the Court Order granting guardianship submitted herewith.

Signature of Parent or Legal Guardian Signature of Parent or Legal Guardian

Print Name of Parent or Legal Guardian Print Name of Parent or Legal Guardian

If a legal guardian grants consent to the marriage of the minor child by executing this document, a certified copy of the court papers granting guardianship must be attached hereto.

Subscribed and sworn to before me this

day of , 20____

My Notary commission expires Signature of Notary Public or Washoe County Deputy Clerk

The signature(s) on this document must be signed before a Notary Public or in the presence of a Washoe County Deputy Clerk. 10/1/2019