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Information For Marriage License Certified Copies
Applicant 1:
First Name
Last Name before Marriage
Applicant 2
First Name
Last Name before Marriage
Marriage Date
ID#
1st Copy:
$10.00
Item Subtotal:
$10.00
Certified Copies (Multiple):
$5.00
Quantity:
Item Subtotal:
$0.00
Total:
$10.00
Mailing Information For Above Items
First Name:
Last Name:
Address:
Address:
City:
State/Province:
ZIP/Postal Code:
Phone:
Email:
Email address is for a receipt only. Certified copies
WILL NOT
be emailed.
Certified copies will be mailed directly to the address above.
Payment Information:
Processing Fee Rates:
Cards:
2.5% ($1.50 min)
Method of Payment:
Credit/Debit Card
Update Name from Above
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
Change Payment Method
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