FORM 7

THE MARRIAGE ACT

(Cap 150)

APPLICATION FOR CERTIFICATE OF NO-IMPEDIMENT TO MARRIAGE

To the Registrar of Marriages,

Whereas I wish to marry:………………………………………………………………………………………………..

(Fill in here the names of the partner to whom you are getting married)

We intend to get married at: …………………………(province), in…………………………….(country)

On:……………………………………………………… (indicate the date when you intend to get married)

I hereby apply for Certificate of No Impediment to Marriage that the Registrar-General is not aware of any
legal impediment to the intended marriage.

AND I hereby declare that I am not already married to any person whether under customary law or any
otherwise howsoever.

My particulars are as follows:

1. Surname:…………………………………………………………………………………………………………………………………………
2. Names:……………………………………………………………………………………………………………………………………………
3. Date of Birth:…………………………………………………………………………………………………………………………………….
4. Place of Birth:……………………………………………………………………………………………………………………..…………….
(indicate location, district and Country where you were born)

5. Your father’s Full names and address: …………………………………………………………………………………………..

(Indicate his sub location, location and District)

6. Your mother’s Full names and address: …………………………………………………………………………………………..

(Indicate his sub location, location and District).

7. Sex 8. Race:…………………………………… (eg. African, Indian, European etc)

M F

8. Religion:………………………………………………………(eg. Christian, Muslim, Jew, traditionalist Buddhist etc)

9. Last residence in Kenya:…………………………………………………………………………………………………………………

(Indicate the location and the district where you last resided in Kenya)

10. Your profession/occupation:……………………………………. (indicate your profession or the work you do)

11. Your Marital Status: ………………………………...........(indicate if you are Spinster, Bachelor, Divorced if
divorced, please attach divorce order, if windowed, please attach death certificate of your deceased
spouse.

Signature:____________________ Date:____________________ Place:_______________________

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GPK1703-5m-7/82