Request For Certified Copy Of Marriage License
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1C
O
V
OMMONWEALTH
F
IRGINIA
Fairfax Circuit Court
4110 Chain Bridge Road
Fairfax, Virginia 22030-4048
JOHN T. FREY
GERARDA M. CULIPHER
Clerk Of Circuit Court
703-246-2770
TDD 703-352-4139
Chief Deputy
Request for Certified Copy of Marriage License
Mail your request to:
Clerk of the Court
Fairfax Circuit Court
4110 Chain Bridge Road, Room 116
Fairfax, VA 22030
Attn: Marriage License Copies
Please include:
1.
A self-addressed stamped envelope. If the self addressed stamped envelope is omitted, your
copies will not be mailed.
2.
The Application for Certified Copy of Marriage License (below).
A money order or cashier’s check in the amount of $2.50 for each copy, payable to the Clerk of
3.
the Court. Personal checks are not accepted.
Please note that if your license was issued between 1997 – 2001, you will need to provide a notarized copy
of either spouse’s state issued identification with your request.
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Application for a Certified Copy of a Marriage License
Book Number: ______
Page Number: ______
Full Name of Bride/Groom/Spouse A:___________________________________________________
(Including any maiden name)
Full Name of Bride/Groom/Spouse B:___________________________________________________
(Including any maiden name)
Date of Marriage:__________________________________________________________________
Daytime telephone number: (In the event we need to reach you.) ____________________________
E-Mail Address:___________________________________________________________________
Number of copies requested: _____
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CCR 152 Marriage License Copy Request Rev 7/15
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