American Samoa Marriage Laws § 42.0103License-Application and forms-Consent of parent or guardian.

(a) Persons wishing to marry shall obtain an application for marriage license from the office of the Registrar of Vital Statistics, which shall be completed and signed by the applicants under oath. Upon payment of the fee of $10, the Registrar of Vital Statistics shall issue to the applicants a marriage license. (b) The application for marriage license shall be substantially in the following form; one of which shall be completed by each applicant, and his or her parent or guardian: APPLICATION FOR MARRIAGE LICENSE I……………………………………, of the Village of……………………………….., American Samoa, being first duly sworn, depose and say: That I am an (American Samoan—other nationality), having been born at…………………… (location of birth) on the……….day of……………. 20….., and that I am... .. years of age; that I am not presently married and that I am not related within the 4th degree of consanguinity to……………………. , the person I propose to marry, and further, that 1 know of no legal impediments to this proposed marriage. …………………………………………….. (Signature) Subscribed and sworn to before me this………………………..day of…………………….,20……... ……………………………………………………………….. (Registrar of Vital Statistics, deputy or a notary public) CONSENT OF PARENT OR GUARDIAN I,……………………………………………. , being first duly sworn, depose and say: That I am the (mother—father—guardian) of…………………………………….. , who is…………….. years of age, being born on the………..day of ………… 20…. , and that I do hereby give my permission for…………………………….. to marry. …………………………………………… (Signature) Subscribed and sworn to before me this……………………….day of……………………… ,20……. ………………………………. (Registrar of Vital Statistics. deputy or a notary public) (c) The application for marriage license shall be in both the English and Samoan languages.

(1962, PL 7-32; 1968, PL 10-52.)