APPLICATION FOR CERTIFIED COPY OF MARRIAGE CERTIFICATE
(Please Print)
Groom’s Full Name ______________________________________________________
Bride’s Full Maiden Name _________________________________________________
Date of Marriage ____________________ Town of Marriage_____________________
INFORMATION OF PERSON MAKING APPLICATION
Name: ___________________________________________________________
Address: __________________________________________________________
Town/City: _________________________ State: _____________ Zip: _________
Phone# ________________________________
Signature: _______________________________________ Date:________________
Fee: $20.00 per copy Number of Copies Requested ____________
TO EXPEDITE YOUR REQUEST PLEASE INCLUDE:
Certified check or money order made payable to: Meriden City Clerk
Please include a stamped self-addressed envelope
Mail To: Denise L. Grandy - City Clerk
142 East Main St., Room 124
Meriden, CT 06450
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