MAIL OR COUNTER APPLICATION FOR A CERTIFIED COPY www.michigan.gov/mdch ____________________________ AUTHENTICATED MICHIGAN DIVORCE RECORD STATE FILE NUMBER (If Known) INFORMATION ABOUT AUTHENTICATED CERTIFICATES Authenticated (exemplified or containing an Apostile) records are typically required by foreign governments for an adoption, work visas, marriage in a foreign country or establishing residency. You must specify which country requires the document. The processing of an authenticated certificate takes approximately 3 to 4 weeks after receipt in the Vital Records office. Please allow additional time for mailing and our Department’s receipting of your payment. APPLICANT (PERSON REQUESTING RECORD) PLEASE PRINT CLEARLY AND LEGIBLY DATE: Applicant’s Name: Address: City/State/Zip: K APPLICANT’S SIGNATURE: K (Sign Here) Must be signed in order to process Daytime Phone: ( ------------------------------------------------------------------------------------------------- ) Home Phone: ( ) K Please specify which FOREIGN COUNTRY requires the document (Cannot be U.S.) REQUESTED DIVORCE OR ANNULMENT INFO If the exact date of the divorce or annulment is unknown, please indicate which year you want us to search. If the record is not found in that year’s files, we will search the files for the year before and the year after. If you want additional years searched, please see the payment box for additional information. DATE OF DIVORCE OR ANNULMENT _____________________________________ Month Day Year NAME OF HUSBAND: WIFE’S NAME AT TIME OF DIVORCE OR ANNULMENT: First First Middle Last Middle Last COUNTY WHERE DIVORCE OR ANNULMENT WAS GRANTED: REQUESTING AN AUTHENTICATED MICHIGAN DIVORCE RECORD The Michigan Vital Records office has records of divorces that occurred in Michigan and were filed with the state since 1897. Some records were not filed with the state. We have no divorce records for Detroit for 1973 and 1974. Anyone is eligible to request a copy of a Michigan divorce record if the application is completed and signed and the required fee is paid. PAYMENT - NO ORDER WILL BE PROCESSED WITHOUT PROPER FEE SUBMITTED WITH A SIGNED APPLICATION SEARCH FEES ARE NON-REFUNDABLE: Fees are established by state statute. A search fee covers the cost of the basic 3-year search and includes either one authenticated copy of the record or an official statement that the record is not filed with the state. A basic search includes the files for the year specified as the death year, as well as the year before and the year after. REFUNDABLE FEES: Payment for additional copies will be refunded if the search indicated that the record is not filed with the state. A refund check would be mailed to you by the Department of Treasury, usually within 3-4 weeks. RUSH SERVICE: Applies to processing time in Vital Records and not the Great Seal. Please allow an add’l 3-4 weeks for the Great Seal to apply the apostille and return it to this office. PAYMENT MUST BE MADE IN U.S. FUNDS BY CHECK OR MONEY ORDER PAYABLE TO THE “STATE OF MICHIGAN” Search (Non-Refundable) $ 29.00 $ Includes One Authenticated Copy ______ Add’l Authenticated Copies ($15.00 for each add’l authenticated copy) $ 15.00 $ EXPEDITED “RUSH” SERVICE (Additional) Additional Search When Exact Date is Unknown: $29.00 fee includes a 3-year search Each additional year is $12.00 per year $ 10.00 $ No. Years $ Specify Which Additional Years to be Searched: ______________________________ _________ $12.00 each TOTAL ENCLOSED: $ WE CANNOT PROCESS YOUR REQUEST WITHOUT PAYMENT. PLEASE REMEMBER TO INCLUDE CHECK OR MONEY ORDER. Mail application with payment to: VITAL RECORDS REQUESTS PO Box 30721 Lansing MI 48909 IF MAILING, QUESTIONS: (517) 335-8666 DCH-0569-DIVAUTH Rev 3/9/06 By Authority of MCL 333.2882(1)(d), MCL 333.2883(2) and MCL 333.2891(1-4) American LegalNet, Inc. www.FormsWorkflow.com