DIOCESE OF VENICE IN FLORIDA CANONICAL PRE-NUPTIAL QUESTIONNAIRE GROOM BRIDE Name Address City/State Telephone Birth-Date Religion-(Rite) Baptism Date (If Convert, indicate date of reception into Catholic Church) Church of Baptism Address City/State/Zip Catholic Party is asked to present Baptismal Certificate issued within the last six months Parties Present Parish Or Church Affiliation Father s Name Religion-(Rite) Mother (Maiden Name) Religion-(Rite) 1
Date of Marriage: Place of Marriage: Address: Witnesses to Marriage AIDS TO HELP THE PRIEST OR DEACON ASSESS THE COUPLES READINESS FOR MARRIAGE NOTE: Priest/Deacon is to note his evaluation in the space provided, or attach his evaluation on a separate sheet. He may use any other approved instruments that will assist him in making the necessary evaluation in each assessment area. SPIRITUAL ASSESSMENT Does the Christian Faith have any influence on their daily lives? Their approaching marriage? What value does religion have for each as an individual? What value will it have in their marriage? Are there areas of religious difference? What faith will they share with their children? What role does public worship have in their lives? How will the faith community help them in their relationship to God? Do they consider marriage as a Sacrament? When do they believe they really receive the Sacrament of Marriage? Will their marriage ceremony be pre-eminently a religious celebration? 2
PERSONAL ASSESSMENT How long have they known each other? Have they been able to communicate effectively with each other? Do they show signs of growing maturity? What is their attitude toward parents, authority, superiors? Do they perceive the basic obligations and responsibilities of marriage? Parenthood? Job? Have they been under doctor s care for any mental or physical ailments? Are there problems with drugs, or alcohol? Do they seem compatible in personality, character, temperament, feelings? 3
CANONICAL ASSESSMENT 1. Has either party been married before? If so, please list the name of previous spouse, date of marriage, and either the date of death or the reference number of the ecclesiastical annulment for every previous union. 2. Has this couple approached any other priest/parish concerning this marriage? 3. Are they entering marriage freely without force, coercion, social pressure? 4. Do they intend to enter a permanent commitment? To be faithful to one another? To eventually rear a family? 5. Are there any other impediments to their marriage, namely Blood or Spiritual Relationships, Vows, Sacred Orders, Impotency, Crimen, Mixed Religion, Disparity of Worship, Age? 4
DECLARATION OF MATRIMONIAL CONSENT Since consent makes marriage, it is essential that a couple be completely familiar with all of the constitutive elements. This declaration is an expression of current theology and canon law and is to be signed at the conclusion of the Prenuptial investigation and preparation. It is important therefore, that its intent be explored and understood by the couple as they prepare for their wedding sacrament. We, in the presence of one another, individually declare our freedom to marry and our freedom from any known impediments between us. We hold marriage to be a life-long and faithful union and process of choosing each other for the mutual sharing of our life and our love; it is a union which is open to children; it is a union which is modeled after and symbolizes God s ever faithful love for His people. It is this partnership of life and love that we seek in marriage and to which we publicly give our consent. Signature of GROOM Signature of BRIDE Date: For Marriage inside of one s proper parish: I am morally certain that the groom and bride are free to marry. Since I do not have moral certitude of the freedom to marry of this groom and bride, an affidavit(s) is (are) attached. _ Officiating Priest/Deacon For Marriage outside of one s proper parish: Permission is hereby granted to to marry outside of his/her proper parish. For Marriage Delegation: _ Pastor/Parochial Vicar Delegation is hereby granted to to serve as the officiating priest/deacon for the marriage of the above identified couple. Pastor/ Bishop s Delegate 5
For Chancery Use Only Chancery No. FRANK J. DEWANE - Bishop of the Diocese of Venice in Florida As Bishop of the Diocese of Venice in Florida, I hereby grant a dispensation from/or permission for: Mixed Marriage Marriage of two Catholics Canonical Form Permission: In the Oriental Rite Permission: Mixed Religion In the Latin Rite Marriage before an Orthodox Priest. Mixed Marriage by a priest in a Dispensation: Protestant Church Marriage before a Minister or Rabbi. Dispensation: Marriage before a Civil Official Disparity of Worship Disparity of Worship (as a precaution) and permission for Mixed Religion Other Dispensation or Permission Given at Venice, Florida on 20 By delegation of +Frank J.Dewane Bishop of the Diocese of Venice in Florida (This rescript is valid for six months from date of issue) Notary Please submit completed Prenuptial Questionnaire along with Affidavits of freedom, baptismal certificate with all notations, FOCCUS results, and Certificate of participation in Marriage Preparation Program at the time of request for either permissions or dispensations. (Revised 05/21/2012) 6