Marriage Certificate Application

Location of Marriage

State where Marriage occurred

City/Town of Marriage

County of Marriage

Island of Marriage

Place of Marriage (City or County)

Borough where License was Issued

Licensing City

Licensing County

Event Type

Date of Marriage

Date of Civil Union

For First Spouse of Record

Preferred Designation

Sex of Groom/Spouse A

Male Female

Groom/Spouse A First Name

Groom/Spouse A Middle Name

Groom/Spouse A Last Name (Before Marriage)

Groom/Spouse A Last Name (After Marriage)

Groom/Spouse A Last Name at Birth

Groom/Spouse A Full Name

Groom/Spouse A Full Birth Name (If Different)

Groom/Spouse A Other married surnames used

Groom/Spouse A Maiden Name (If Different)

Groom/Spouse A Suffix

Groom/Spouse A First Name (If Previously Married and Different from Current Name)

Groom/Spouse A Middle Name (If Previously Married and Different from Current Name)

Groom/Spouse A Last Name (If Previously Married and Different from Current Name)

Groom/Spouse A County of Residence (At time of marriage)

Groom/Spouse A State of Residence (At time of marriage)

Groom/Spouse A Date of Birth

Groom/Spouse A State/Country of Birth

Groom/Spouse A County of Birth

Groom/Spouse A Social Security Number

Father/Parent Name of Groom/Spouse A (Prior to First Marriage)

Mother/Parent Name of Groom/Spouse A (Prior to First Marriage)

For Second Spouse of Record

Sex of Bride/Spouse B

Male Female

Bride/Spouse B First Name

Bride/Spouse B Middle Name

Bride/Spouse B Last Name (Before Marriage)

Bride/Spouse B Last Name (After Marriage)

Bride/Spouse B Last Name at Birth

Bride/Spouse B Other married surnames used

Bride/Spouse B Full Name

Bride/Spouse B Full Maiden Name

Bride/Spouse B Full Birth Name (If Different)

Bride/Spouse B Maiden Name (If Different)

Bride/Spouse B Suffix

Bride/Spouse B First Name (If Previously Married and Different from Current Name)

Bride/Spouse B Middle Name (If Previously Married and Different from Current Name)

Bride/Spouse B Last Name (If Previously Married and Different from Current Name)

Bride/Spouse B County of Residence (At time of Marriage)

Bride/Spouse B State of Residence (At time of Marriage)

Bride/Spouse B Date of Birth

Bride/Spouse B State/Country of Birth

Bride/Spouse B County of Birth

Bride/Spouse B Social Security Number

Father/Parent of Bride/Spouse B (Prior to First Marriage)

Mother/Parent of Bride/Spouse B (Prior to First Marriage)

Customer Info

First Name

Middle Name

Last Name

Applicant Name

Phone Area Code

Phone Number

Phone Number (First 3 Digits)

Phone Number (First 4 Digits)

Work Phone Number

Email address

Your Birthdate

Type of Current Valid Photo ID

Photo ID Number

State of Issuance

Expiration Date

Relation to person of record

I am applying for the marriage certificate of

Relation to person on record

Relation to person of record

I am applying for the death record of

Relation to person of record

Relation to person on record

Family, specify

Who are you the authorized representative for?

Specify your personal/property interest

Certificate Request

Please provide the reason why the marriage certificate is being requested, along with other required details regarding the certificate request.

Reason for Request

Specify country of use

Date of Request

Have there been any corrections or legal changes made to the information on this certificate?

Yes No

Do you want the registrants' Social Security numbers on the copy of the certificate?

Yes No

Marriage Certificate Number (if known)

Marriage License Number (If Known)

Local Registration Number (if known)

State File Number (If known)

Select Record Type

How many certified copies of the marriage license are you requesting?

Do you want to receive the marriage long form or statement of marriage?

Marriage Long Form Statement of Marriage

How many certified copies of the marriage application are you requesting?

How many additional copies of the marriage long form are you requesting?

How many copies of the marriage certificate are you requesting?

Type of Copy

Which form do you want to receive?

Long Form Abstract

How many additional copies of the statement of marriage are you requesting?

Mailing Address

Please enter the address where you would like the marriage certificate to be delivered.

Street

Apt, Suite, Floor, Etc.

City

State

City, State

Zip Code

City, State ZIP code

Mailing Address

By checking this box, I agree to submit the information provided to this website, and I authorize Vital Records Online to use my information to fill all necessary documents in order to prepare my application materials. I understand that VitalRecordsOnline.com is a private document preparation service and that I am hiring them to prepare my birth certificate application materials. I understand there is a service fee charged by VitalRecordsOnline.com and I will pay the health department required fee directly by check or money order. I understand I may have to provide additional documents or notarized documents to the health department in order to prove my identity. I understand that I may receive newsletters from Vital Records Online. By submitting the form above, I agree to these terms and the terms of this website.

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Location of Marriage

For First Spouse of Record

For Second Spouse of Record

Customer Info

Certificate Request

Mailing Address

FAQs