Fillable AFFIDAVIT FOR DUPLICATE MARRIAGE LICENSE (Pinellas County Clerk of the Circuit Court and Comptroller)

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AFFIDAVIT FOR DUPLICATE MARRIAGE LICENSE (Pinellas County Clerk of the Circuit Court and Comptroller)

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BROWSE PINELLAS COUNTY CLERK OF THE CIRCUIT COURT AND COMPTROLLER FORMS

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STATE OF FLORIDA
PINELLAS COUNTY
AFFIDAVIT FOR DUPLICATE
MARRIAGE LICENSE
Pursuant to F.S. 741.10, this affidavit is being provided to support a
marriage between and .
(Spouse) (Spouse)
A marriage ceremony for and was
(Spouse) (Spouse)
held on , in , FL.
(Date) (Ci
ty)
The marriage was performed by ,
(Offi
c
iant’s Name & Title)
whose address is .
(Officiant’s Street Address, City, State, Zip Code)
Signed: Signed:
(First Witness) (Second Witness)
(Printed Name of First Witness) (Printed Name of Second Witness)
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
Revised 02/04/2020
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AFFIDAVIT FOR DUPLICATE MARRIAGE LICENSE (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 10 February 2021

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