Middle
Name:
Maiden
Last Name:
First
Name:
Middle
Name:
First
Name:
State: Zip Code: Town:
Date of Marriage:
Current
Address:
/ /
Daytime
Phone #
( )
-
Date:
Card Type: _______
Exp. Date: __ _____ ______
Bride / Groom / Spouse
Please indicate
TOWN CLERK
1
14-6537
How to Obtain a Certified Copy of a Marriage Certificate
Please provide us with the following information so we can process your request
Bride / Groom / Spouse
Please indicate
$6.00 Credit Card Processing Fee
Money Order:
Check:
* Please call for Rates
UPS Overnight:
Regular Mail:
# Of Copies requesting
($ 10.00 Per Copy)
-
-
Credit Card
Return Mailing
Checks and Money Orders Payable to Kate Murray, Town Clerk
** ALL Checks outside of Nassau County, NY Will be held for 16 Business Days **
Maiden
Last Name:
Apt #
* Please include your Photo ID With your request *
Send all of your correspondence to
Kate Murray, Town Clerk
Hempstead Town Hall
1 Washington Street
Hempstead, NY 11550
ATTENTION: MARRIAGE BUREAU
-
Rev. 1/20
KATE MURRAY
Donald X. Clavin Jr.
Supervisor
Mastercard
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