Marriage Certificate Requests

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PLEASE RETURN THIS FORM TO: VITAL RECORDS, 2600 SKYLAND DRIVE, NE, ATLANTA, GA 30319
MARRIAGE CERTIFICATE REQUESTS
Please indicate below the type and number of copies requested and forward this form with either a money order or certified check for the
correct amount, made payable to Vital Records.
[
]
Full size copy $10.00; additional copies are $5.00 each at this time
[
]
Total Number of Copies Requested
NOTE: Records prior to June 9, 1952 must be requested at the Office of the Probate Judge in the county where the license was issued If you are requesting a
marriage certificate prior to this date, complete this application and mail it to the county’s Probate Court’s office in which the marriage was granted. Contact
their office concerning their fee requirements, as their prices may differ from our prices.
COMPLETE ALL INFORMATION FOR THE MARRIAGE RECORD BEING REQUESTED:
Groom’s Name:__________________________________________________________________________________________________________________
(First)
(Middle)
(Last)
Bride’s Name:___________________________________________________________________________________________________________________
(First)
(Middle)
(Last)
Date of Marriage: ________________________________________________________________________________________________________________
(Month)
(Day)
(Year)
Place of Marriage:________________________________________________________________________________________________________________
(City)
(County)
(State)
Signature of Requestor:____________________________________________________________________________________________________________
Relationship (if other than Bride or Groom):___________________________________________________________________________________________
DIVORCE VERIFICATION REQUESTS ONLY
Please indicate below the type and number of verifications requested and forward this form with either a money order or certified check for the correct
amount, made payable to Vital Records. Divorce records are kept for statistical purposes only; therefore, copies are never issued by the State Office.
[
] One Certified Statement $10.00; Additional statements are $5.00 at this time
[
] Total Number of Statements Requested
NOTE: Records prior to June 9, 1952 must be requested at the Clerk of the Superior Court in the county where the divorce was granted. If you are requesting
a divorce record prior to this date, complete this application and mail it to the Clerk of the Superior Court in the county where the divorce was granted.
Contact their office concerning their fee requirements, as their prices may differ from our prices.
COMPLETE ALL INFORMATION FOR THE DIVORCE VERIFICATION BEING REQUESTED:
Groom’s Name:__________________________________________________________________________________________________________________
(First)
(Middle)
(Last)
Bride’s Name:___________________________________________________________________________________________________________________
(First)
(Middle)
(Last)
Date of Divorce:_________________________________________________________________________________________________________________
(Month)
(Day)
(Year)
Place of Divorce:_________________________________________________________________________________________________________________
(City)
(County)
(State)
Signature of Requestor:____________________________________________________________________________________________________________
Relationship (if other than Bride or Groom):___________________________________________________________________________________________
MAILING ADDRESS
List below the name and address of the person to whom the certificate is to be mailed and indicate their relationship to the person whose
name is on the certificate:
Name:___________________________________________________________________ Relationship: _____________________________
Address: __________________________________________________________________________________________________________
(No. & Street or RFD and Box No.)
(Apt. No.)
__________________________________________________________________________________________________________
(city)
(state)
(zip code)

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