Certificate of No Impediment — The Sacrament of Holy Crowning

Certificate of No Impediment

Complete this form to certify that you are free of marriage impediments. All fields marked with an asterisk are required. Your information will be reviewed by the issuing priest.

Name Identification

First Name *

Middle Name

Last Name *

الاسم بالعربية (if applicable)

الاسم الأول

اسم الأب

اسم الجد

Date of Birth *

Town / City of Birth *

Country of Birth *

Father's Name

First Name *

Middle Name

Last Name *

Mother's Name

First Name *

Middle Name

Last Name *

Current Address

Street Address *

Town / City *

State / Province *

Postal / Zip Code *

Country of Residence *

Immigration Status *

Completed by Priest

Marital History

Current Marital Status *

Has the applicant been engaged before? *

No Yes

Number of Times

Year(s)

Has the applicant been married before? *

No Yes

Number of Times

Year(s)

Is the applicant a widow / widower? *

No Yes

Number of Times

Year(s)

Prior Marriage Details

If you have been previously married, provide the details below.

Type of Prior Marriage(s) *

Indicate the number of each type.

Church

Civil

Cohabitation

Clerical Council That Issued Remarriage Permit

Date of Remarriage Permit

Reference Number

Completed by Priest

Spiritual Information

Liturgy Attendance *

Regular Sporadic Rare

Partaking of Holy Communion *

Regular Sporadic Rare

Confession *

Regular Sporadic Rare

Church Meetings / Services Attended

Specify the names and how frequently you attend (e.g. Sunday School — weekly, Bible Study — monthly).

Father of Confession *

Parish *

Completed by Priest

Certificate Coverage Period

This certificate may cover the parishioner's entire history or a limited period, depending on how long the issuing priest has known the parishioner.

Coverage *

Entire history of marital & spiritual status Limited period

From (Month / Year)

To (Month / Year)

Parishioner Declaration

I, the above named parishioner, hereby declare that I have reviewed the contents of this certificate and affirm they are true and accurate.

Full Name *

Date *

Draw Your Signature *

Use your mouse or touchscreen to sign in the box below.

Required Documents

Parishioner Photo *

Passport-style photo — JPG or PNG, max 5MB

✓ File selected

Valid Photo ID *

Government-issued ID (passport, driver's license, or national ID card) — PDF or image, max 10MB

✓ File selected

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