Microsoft Word - Issuance of Marriageability CertificateLast Rev: Aug 2017 Page 1 of 5
Home Department / Marriageability Certificate (under The Special Marriage Act 1954) / ( 1954 )
For Official Use Only RTS Service Code: 137
Application Number / : Date of Application /
/ / Name of Block & Tehsil
Fields marked with asterisk (*) are mandatory/ (*) ,
Part – 1 Personal Details of the Applicant /
Details of Person Filling the Application Form /
Self Attested Photo of
3. Relation with Beneficiary /

Personal Data of Beneficiary / 4. Name / *
5. Gender / * Male / Female /
6. Date of birth / 7. Age (if Date of birth not known)/ ( )
8. Place of Birth /
9. Father's Name / *
10. Mother's Name /
11. Address / *
PIN Code / District / *
12. Marital Status / 13. Spouse Name / /
14. Email ID / 15. Contact Phone Number /
*
16. Voter ID Card Number /

)
Aadhaar Enrollment Number (if Aadhaar not issued)/
( )
Part – 2 Service Details /
Application Details /
18. Mode of Delivery / *
o Sewa Kendra /
o By Post /
19. Application processing Office / *
20. Does social security number (SSN) exist? / (
) ? *
21. If yes, mention social security number (SSN) details / ,
( ) *
22. Current Address of Prospective Bride / Bridegroom in foreign country /
*
23. Date till unmarried / *
24. Date of leaving India / *
Last Rev: Aug 2017 Page 2 of 5
Part -3 List of Required Documents / . Please tick (√) the document attached / (√)
Name of Documents / Whether Mandatory / Optional / /
1. Copy of Power of Attorney / Optional /
2. Copy of Passport / Mandatory /
3. Self Declaration / Mandatory /
4. Copy of Proof of Date of Birth / Mandatory /
5.
Copy of Ration Card’s First Page & Second Page / Voter Card / Adhar Card / Driving License / Passport / / /
/ |
Mandatory /
6. Any Other Attachment / Optional /
I confirm that I have been residing in India for at least 182 days in the preceding 12 months & information
(including biometrics) provided by me to the UIDAI is my own and is true, correct and accurate. I am aware
that my information including biometrics will be used for generation of Aadhaar and authentication. I
understand that my identity information (except core biometric) may be provided to an agency only with my
consent during authentication or as per the provisions of the Aadhaar Act. I have a right to access my identity
information (except core biometrics) following the procedure laid down by UIDAI. / w?A s;dhe eodk jK fe
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/
/
AFFIDAVIT
1. That I personally know _______________________________________________________________
S/O / D/O ______________________________________________________R/O__________________
and place of birth is____________________________________________________________________
3. That the above said is unmarried.
4. That the above said is eligible for marriage by his / her age.
5. That in the capacity of Sarpanch/Namberdar/MC of village/Ward No, I have no objection if the above said may marry with any girl / boy as per his / her own choice, irrespective of caste and creed anywhere in India or Aboard.
Verification:- DEPONENT Verified that the contents of my above affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.
Verified at ……………………………………………………….
Date: DEPONENT
AFFIDAVIT
1. That ___________________________________________________________________is my real address and
presently I am residing at ____________________________________________________________________
2. That the date of birth of my said ___________________________is __________________________ And place
of birth is______________________________
3. That my said ___________________is still unmarried and has no spouse living here in India so far.
4. That my said ____________________is not with is the degree of prohibited relationship with any girl/women
of any caste, creed or nationality in India or at abroad with his own choice and will.
5. That my said _____________________ is in need of his marriage ability certificate for the purpose of solemnizing
his marriage.
6. I have no objection if my said ____________________________ engages any girl for his marriage as per his own
choice and will irrespective of caste and creed anywhere in India or at abroad.
Verification:- DEPONENT
Verified that the contents of my above affidavit are true and correct to the best of my knowledge and belief and nothing
has been concealed therein.
Feed Back Form/
1. Is there any unnecessary information being asked in the Form?/

Yes/ No/
If Yes, Please specify the detail/ ,
2. Is any vague information is being asked in the form?/

Yes/ No/
If Yes, Please specify the details/ ,
3. Is the space provided in the form is sufficient for filling up the
required information?/

Yes/ No/
If No, Please specify the details/ ,