(c) A marriage license application shall include the following information:
- (1) Name, sex, occupation, address, social security number, and date and place of birth of each party to the proposed marriage;
- (2) If either party was previously married, his or her name, and the date, place, and court in which the marriage was dissolved or declared invalid or the date and place of death of the former spouse;
- (3) Name and address of the parents or guardian of each party;
- (4) Whether the parties are related to each other and, if so, their relationship; and
- (5) The name and date of birth of any child of which both parties are parents, born before the making of the application, unless their parental rights and the parent and child relationship with respect to the child have been terminated.
- (6) A certificate of the results of any medical examination required by either applicable tribal ordinances, or the laws of the State in which the Indian country under the jurisdiction of the Court of Indian Offenses is located.