Application for Marriage Certificate
Payment due is $10.00 per copy
In Person: We accept cash, money order,
MasterC
ard, Visa and American Express.
By Mail: We only accept money orders
made payable to "The City of White
Plains"
We do not accept personal checks.
CERTIFICATEINFORMATION:
Middle Name Last Name (at birth)
Place License
was issued
Date of
Marriage
Purpose record is
required
APPLICANT INFORMATION:
Full Name Relationship
Telephone Number Address
Signature
_________________________________________
Date
City Clerk 255 Main Street White Plains, NY 10601 (914) 422-1227
YOUR CHECKLIST:
Identification Requirements (One of the following)
Driver's License or Non-driver's ID
Passport or Naturalization Papers
Military ID
Two (2) different (and current) utility bills showing applicant's
name and address
Police report of lost or stolen ID
IDENTIFICATION CANNOT BE EXPIRED
PLEASE NOTE: Copies of marriage certificates are only available to the persons
named on the record. Anyone else must call our office for further instructions.
Middle Name Last Name (at birth)
First Name
First Name
PARTY 1
PARTY 2
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