Fillable Bride/Groom/Spouse TYPE OF RECORD DESIRED (Enter Number of (TOWN OF NORTH HEMPSTEAD)

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Bride/Groom/Spouse TYPE OF RECORD DESIRED (Enter Number of (TOWN OF NORTH HEMPSTEAD)

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NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Sectio
n
A
pplication to Town/City Clerk for Copy of Marriage Record
DOH-301 (8/11) Page 1 of 3
TYPE OF RECORD DESIRED (Enter Number of Copies)
Search and
Certified Transcript
(Certificate)
Fee $10.00 per
copy
Search and
Certified Copy
(Long Form)
Fee $10.00 per
copy
A Certified Transcript is an abstract from the marriage record issued under
the seal of the town/city clerk. It includes the names of the contracting parties,
their residence at the time the license was issued, date and place of
marriage as well as date and place of birth of the bride and groom.
A Certified Transcript may be used as proof that a marriage occurred.
A Certified Copy includes all of the items of information occurring on the original
record of the marriage.
A Certified Copy may be needed where proof of parentage and certain other
detailed information may be required such as: passports, veteran's benefits, court
proceedings, or settlement of an estate.
Bride/Groom/Spouse
Name (as recorded on marriage license): Date of Birth:
(or age at time of marriage)
First Middle Last Birth Name (if different)
If Previously Married, State Name Used at that Time:
Residence (at time of marriage):
First
Middle
Last
County
State
Bride/Groom/Spouse
Name (as recorded on marriage license): Date of Birth:
(or age at time of marriage)
First Middle Last Birth Name (if different)
If Previously Married, State Name Used at that Time:
Residence (at time of marriage):
First Middle Last County State
Marriage Information:
Place Where Marriage License Was Issued: Place Where Marriage Was Performed:
Marriage Certificate No.:
(if known)
Local Registration No.:
(if known)
Town or Cit
Count
y
Town or Cit
Count
y
Purpose for which record is required:
Date of Marriage or Period Covered by
Search:
In what capacity are you acting?:
What is your relationship to person whose record is
required?:
(If self, state "SELF".)
Married on or
Search from:
(mm / dd / yyyy)
If attorney, give name and relationship of your client to person whose record is required:
Search to:
(if searching period)
(mm / dd / yyyy)
Signature of Applicant: Date: Applicant's Phone Number:
Name of Applicant:
Please print name and address where record is to be sent:
A
ddress of Applicant:
City State ZIP City State ZIP
* 1881 to present ($30.00 per copy)
If a state issued copy is required
or you are not certain in which
city or town outside of New York
City the license was issued.
* 1880 - 1907 and license issued in
the cities of Albany, Buffalo or
Yonkers.
Where to Apply for Record of Marriage
1. License Issued in New York State (Outside of New York City)
Year of Marriage Apply to:
* 1881 to present
($10.00 per copy) Town or City Clerk
Where license was issued (purchased)
New York State Department of Health
Vital Records Certification Unit
P.O. Box 2602
Albany, NY 12220-2602
www.health.ny.gov/vital_records/marriage.htm
Albany: City Clerk
City Hall - 24 Eagle St Rm 202
Albany, NY 12207
Buffalo: City Clerk
65 Niagara Square
Buffalo, NY 14202
Yonkers: City Clerk
40 S Broadway Rm 107
Yonkers, NY 10701
2. License Issued in New York City
Contact the office of the New York City Clerk for information if the marriage license was
issued in any of the five boroughs of New York City:
www.cityclerk.nyc.gov
Manhattan City Clerk of New York
141 Worth Street
New York, NY 10013
(212) NEW-YORK / (212) 639-9675
Brooklyn (also known as Kings)
Bronx
Queens (Records prior to 1898 are on file with the New York State Department of
Health)
Richmond (also known as Staten Island)
(Records prior to 1898 are on file with the New York State Department of
Health)
PLEASE NOTE: Records of marriages in areas of the present City of New York,
which were not part of the city at the time of
marriage, are on file with the State Department of
Health.
DOH-301 (8/11) Page 2 of 3
Application to the Town Clerk for Copy of Marriage Record
Type of record desired.
Certified Copy
A photographic reproduction of the actual marriage license.
Certified
Transcript
A Certified Transcript includes all of the items of information
occurring on the original record of marriage.
Certification
A Certification, an abstract from the marriage record issued by the
Clerk under seal and includes the names of the contracting parties,
their residence at the time the license was issued and the date and
place of birth of the bride and groom.
A Certified Copy or Certified Transcript of marriage can only be issued to the bride, the
groom, legal representative or anyone who can demonstrate a legal claim. A Certified Transcript
may be needed where proof of parentage and certain other detailed information may be
required such as: passports, veteran’s benefits, court proceedings, or settlement of an estate.
A Certification of marriage also can only be issued to the bride, groom, legal representative or
anyone who can demonstrate a legal claim. The Certification can be used as proof that a
marriage occurred.
Forward Mail Requests To:
Town Clerk - Town of North Hempstead
200 Plandome Road P. O. Box 3000
Manhasset, New York 11030
Include a Stamped, Self-addressed envelope with:
1. A $10 Money Order for each copy ordered.
2. A Photo copy of the requestor’s Identification. (State Motor Vehicle
Driver’s license, Non-Driver I D, Passport or other birth related I D)
3. Give bride and groom’s names, date and place where license was
issued, place of marriage, and purpose record is being requested.
Note: If bride was previously married, state name used at that time.
Priority Handling
* In addition to the requirements above: Send request via FEDEX, USPS,
UPS or other overnight carrier and include a pre-paid, self-addressed
return envelop and applicable pick-up charges. (Example, UPS charges $
6.95 for pick-up of all pre-paid envelops & packages)
DOH-301 (8/11) Page 3 of 3
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BrideGroomSpouse TYPE OF RECORD DESIRED (Enter Number of (TOWN OF NORTH HEMPSTEAD)

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Completed 14 July 2020

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