Application For Certified Copy Of Marriage Or Divorce Certificate
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1STATE OF WYOMING
APPLICATION FOR CERTIFIED
Name of Husband
COPY OF MARRIAGE OR DIVORCE
CERTIFICATE
First Name
__________________________
Middle Name __________________________
A request for a certified copy of a marriage or divorce
Last Name
__________________________
certificate should be submitted on this form along with
the fee of $13.00 per copy. A money order or a
Name of Wife
personalized check from the person making the request
should be made payable to VITAL RECORDS
First Name
__________________________
SERVICES. If a record is not located, your fee will be
retained as a searching fee.
Middle Name __________________________
Please enclose a self-addressed, stamped envelope
Last Name
__________________________
with the application.
Maiden Name __________________________
Type of record requested
(check one): Marriage____ Divorce____
Date of Occurrence
_____/_____/_____
Enclosed is $_______for______certified copy/copies.
Place of Occurrence
The fee listed above includes a surcharge for the
City_________________ or County________________
Wyoming Children’s Trust Fund used to establish
programs for the prevention of child abuse and neglect.
Address to Which Copy Should be Mailed
Wyoming Statute 35-1-428 requires Vital Records
Services to collect this surcharge on all certified copies
__________________________________
and search of the files.
__________________________________
__________________________________
Signature of Husband or Wife Named on Certificate
X__________________________________
PHOTOCOPY OF IDENTIFICATION
Written signature must be a permanent
Part of ID
Mail your request to:
Vital Records Services
Hathaway Building
Cheyenne, WY 82002
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