Application To Request An Authenticated Statement Of No Marriage In Michigan Form printable pdf download

Application To Request An Authenticated Statement Of No Marriage In Michigan Form

APPLICATION TO REQUEST AN

AUTHENTICATED STATEMENT OF NO MARRIAGE IN MICHIGAN

REQUESTING A SEARCH FOR A STATEMENT OF NO MARRIAGE: Most foreign governments require an official state-

ment of NO MARRIAGE (or SINGLE STATUS) which contains an “apostille” to be presented by a U.S. citizen in order to be

married in a foreign country. The statement needs to indicate that a statewide search was conducted and would confirm that

there is NO RECORD of a marriage recorded for the applicant in the State of Michigan and the years searched would be speci-

PART 1: APPLICANT’S INFORMATION

(Person Requesting Record)

Applicant’s

Name:______________________________________________________________________________________________

Mailing Address: ______________________________________ City: ____________________ State: _____ Zip: ________

Daytime Phone (

) ________________________________ Other Phone: (

) ________________________________

PART 2: CERTIFICATION OF INFORMATION PROVIDED

By signing this application, I understand that I am agreeing to pay for a search of the State of Michigan Vital Records with the

information that I provided. This does not guarantee that a record will be found.

►

_________________________________

: __________

Applicant’s Signature:

Date

PART 3: PURPOSE FOR REQUESTING THE RECORD

PART 4: SPECIFY COUNTRY OF USE

PART 5: INFORMATION NEEDED TO SEARCH

□

Are you the

BRIDE

GROOM

A separate search is needed for the prospective bride

and groom, if both are residents of Michigan. The search

Begin Search With Year _________

should be conducted for the years when the applicant

resided in Michigan since the age of 18, or since the year

Additional Years To Be Searched

of the latest divorce. The country of use may also require

_______________

________________

authenticated copies of previous marriages and divorces.

(See Part 6 For Fees)

YOUR

YOUR DATE

NAME

OF BIRTH

First

Middle

Last

mm/dd/yyyy

YOUR

FATHER’S

NAME

First

Middle

Last

YOUR

MOTHER’S

NAME

First

Middle

Last

If you have been married and divorced since

the age of 18, please indicate date and place.

Date (mm/dd/yyyy)

County

State

PART 6: FEES -

Includes one certified copy or no-find letter

Base Fee:

Includes One Year Search

$42.00

$ 42.00

Additional Certified Copies (Each)

____ x $26.00

Additional Years Search (Number of years)

____ x $12.00

Indicate years you want searched: _____ _____ _____

_____ _____ _____ _____ _____ _____ _____ _____

EXPEDITED “RUSH” SERVICE (Additional)

$25.00

For Accounting Use Only

PAYMENT TO “STATE OF MICHIGAN”

TOTAL:

Is your request complete? See checklist on back!

Application To Request An Authenticated Statement Of No Marriage In Michigan Form

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