Fillable AFFIDAVIT AMENDMENT TO MARRIAGE LICENSE STATE OF FLORIDA (Pinellas County Clerk of the Circuit Court and Comptroller)

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AFFIDAVIT AMENDMENT TO MARRIAGE LICENSE STATE OF FLORIDA (Pinellas County Clerk of the Circuit Court and Comptroller)

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STATE OF FLORIDA
PINELLAS COUNTY
AFFIDAVIT AMENDMENT
TO MARRIAGE LICENSE
I am requesting an amendment to my marriage license as recorded in
Book Page to correct the following:
I am hereby providing a copy of the documentation supporting the need for the amendment.
Signed: Signed:
Spouse Spouse
Printed Name of Spouse Printed Name of Spouse
Sworn to and subscribed before me by means of ☐ Physical Presence or ☐ Online Notarization
on this
____ day of __________, 20___ by ___________________ & ___________________.
Who are personally known ____ or produced the following identification ________________.
__
____________________________________ OR _______________________________________
Deputy Clerk Notary Public or Authorized Official SEAL
______________________________________ ______________________________________
Name printed/typed Name printed/typed
Re
vised 02/04/2020
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AFFIDAVIT AMENDMENT TO MARRIAGE LICENSE STATE OF FLORIDA (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 9 February 2021

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