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IN THE DISTRICT COURT OF _______________COUNTY STATE OF OKLAHOMA Disclosure of Premarital Counseling

ML - ________ - _____________

We hereby attest that _________________________, a resident of _______________________
(Full Name of Bride) (Street Address)

__________________________________ and ___________________________, a resident of
(City, State, and Zip Code) (Full Name of Groom)

_____________________________, ____________________________ attended a premarital
(Street Address) (City, State, and Zip Code)

counseling program conducted by ________________________________. The program was _______ hour(s) in length. (A minimum of four (4) hours of marriage education curriculum is required). The training must be conducted by a health professional, an official representative of a religious institution or a person trained by the principal authors or duly authorized agents of the principal authors of nationally recognized marriage education curriculum including, but not limited to, Prevention & Relationship Enhancement Program (PREP). The certificate of completion of this program must be attached or the person conducting the counseling must sign the document below.

(Signature of Bride)

(Signature of Groom)

I hereby attest that I performed the counseling described above.

(Signature of Counselor)

Dated this ________ day of __________________, 20___.

AO C Form 81 (R evised 10/06)