Application For Marriage Record
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Application For Marriage Record Form. This is a Michigan form and can be use in Genesee Local County.
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Tags: Application For Marriage Record, Michigan Local County, Genesee
GENESEE COUNTY CLERK
APPLICATION FOR MARRIAGE RECORD
(Please Print)
APPLICANT INFORMATION
(Person Requesting Record)
Applicant's Name: _____________________________________________________________________
Address: ____________________________________________________________________________
City/State/Zip_________________________________________________________________________
Daytime phone number to contact you if there is a problem: (
) ____________________________
APPLICANT'S SIGNATURE:
________________________________________________________
Must be Signed in Order to Process
REQUESTED MARRIAGE INFORMATION
(Marriage License Must Have Been Obtained in Genesee County)
Name of Groom: _____________________________________________________________________
First
Middle
Last
Name of Bride: ______________________________________________________________________
First
Middle
Maiden
Date of Marriage: ______________________________________
Month
Day
Year
The fee is $10.00 for the first copy, and $5.00 for EACH ADDITIONAL COPY of the same record when
ordered at the same time as the first copy.
Number of Copies Requested: ____________
Mail this application with a MONEY ORDER payable to:
Genesee County Clerk
Vital Records
900 S. Saginaw St.
Flint, MI 48502
For additional information call (810) 257-3225
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