Fillable MARRIAGE LICENSE APPLICATION (Kern County Clerk)

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MARRIAGE LICENSE APPLICATION (Kern County Clerk)

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The MARRIAGE LICENSE APPLICATION (Kern County Clerk) form is 1 page long and contains:

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  • 9 check-boxes
  • 48 other fields

Country of origin: US
File type: PDF

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BROWSE KERN COUNTY CLERK FORMS

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MARRIAGE LICENSE APPLICATION
Ceremony must take place in California Ceremony must take place in California
Choose Public Must have at least one witness present Confidential No witness required
One: $101 Public Record kept at Hall of Records $123 Private record kept at County Clerk Office
Must be living together as spouses
PLEASE NOTE: THE FEE MUST BE PAID BY MONEY ORDER, MAKE PAYABLE TO KERN COUNTY CLERK.
READ THESE INSTRUCTIONS BEFORE YOU SIGN THIS APPLICATION. PLEASE PRINT LEGIBLY.
*YOUR MARRIAGE MUST BE SOLEMNIZED BY A PERSON AUTHORIZED TO PERFORM MARRIAGES IN CALIFORNIA AS PROVIDED IN FAMILY CODE
SECTIONS 400-401.
*YOUR CEREMONY MUST BE PERFORMED WITHIN 90 DAYS FROM THE DATE THE LICENSE IS ISSUED. YOU MUST BE MARRIED ON OR AFTER THE
ISSUANCE DATE AND ON OR BEFORE THE EXPIRATION DATE OF THE LICENSE. LICENSES NOT USED WITHIN THE TIMEFRAME ARE VOID.
*ABSOLUTELY NO REFUNDS WILL BE GRANTED * ALL BOXES MUST BE COMPLETED
FIRST PERSON DATA Groom Bride
SECOND PERSON DATA Groom Bride
First Name:
First Name:
Middle Name:
Middle Name:
Current Last Name:
Current Last Name:
Legal Last Name (by birth, adoption, naturalization, if different
from current last name):
Legal Last Name (by birth, adoption, naturalization, if different
from current last name):
Date of Birth:
State/Country of Birth:
Date of Birth:
State/Country of Birth:
# of Previous Marriages/SRDP (State Registered Domestic
Partnership):
# of Previous Marriages/SRDP (State Registered Domestic
Partnership):
Last Marriage Ended (check one):
[ ] Death [ ] Dissolution [ ] Annulment [ ] Term. SRDP [ ] N/A
Last Marriage Ended (check one):
[ ] Death [ ] Dissolution [ ] Annulment [ ] Term. SRDP [ ] N/A
Date Ended:
Date Ended:
Daytime Phone Number:
Daytime Phone Number:
Street Address:
Street Address:
City:
Zip:
City:
Zip:
Full Birth Name of Father/Parent:
Full Birth Name of Father/Parent:
State of Birth of Father/Parent (if outside USA list country):
State of Birth of Father/Parent (if outside USA list country):
Full Birth Name of Mother/Parent (maiden):
Full Birth Name of Mother/Parent (maiden):
State of Birth of Mother/Parent (if outside USA list country):
State of Birth of Mother/Parent (if outside USA list country):
** OPTIONAL** NEW MIDDLE AND/OR NEW LAST NAME OF FIRST PERSON
(This will be your new legal name)
First Name – Must be same as above
New Middle Name – Must be same as above if not changing
New Last Name
** OPTIONAL** NEW MIDDLE AND/OR NEW LAST NAME OF SECOND PERSON
(This will be your new legal name)
First Name – Must be same as above
New Middle Name – Must be same as above if not changing
New Last Name
WE, THE UNDERSIGNED, DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING INFORMATION IS
TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE AND BELIEF.
SIGNATURE OF FIRST PERSON
SIGNATURE OF SECOND PERSON
*** FOR OFFICE USE ONLY ***
I.D.# EXP
I.D.# EXP
EMAIL ADDRESS (REQUIRED):
✔
INFORMATION REGARDING THE NAME EQUALITY ACT OF 2007
One or both parties to a marriage may elect to change the middle or last names by which that party wishes to be
known after they are married by entering the new name in fields 30A thru 31C, as applicable, on the marriage
license application at the time they are applying for the marriage license. The parties may choose any of the
following as the name they wish to be known as after marriage [FC § 306.5(b)(2)]:
Middle Name:
Current last name of either spouse
Last name of either spouse given at birth
A hyphenated combination of the current middle name and the current last name of the person or spouse
A hyphenated combination of the current middle name and the last name given at birth of the person or spouse
A hyphenated combination of last names
Last Name:
Current last name of the other spouse
Last name of either spouse given at birth
A name combining into a single last name all or a segment of the current last name or last name of either spouse
given at birth
A hyphenated combination of last names
NOTE: You may not change your first name using this process. IMPORTANT: You may not amend the
marriage license after it has been issued to add or change the name you wish to be known as after you are
married. The name you indicate on the marriage license application will be your name on the marriage
license/certificate and cannot be changed by the County Clerk.
You are not required to change your name, nor are parties required to have the same name.
If one or both parties do not wish to identify a new name on the marriage license, fields 30A thru 31C, as
applicable, on the marriage license will be completed with two single dashes. You may not change the
information on the marriage license after it has been issued by the County Clerk.
The marriage certificate is used by multiple local, state, federal and private agencies, each of which have different
rules and/or regulations regarding what documents are acceptable to change your name on their records following
marriage. It is recommended that you contact these agencies to verify their requirements prior to applying for
your marriage license.
It is unlawful for our employees to answer questions of a legal nature. County Clerk staff cannot advise you how to
complete the marriage license application as it relates to your entry of a new name or retention of your former name
on the marriage license application. For your protection, if you have any questions regarding whether you should or
should not list your new name on the marriage license application, and/or how the Name Equality Act of 2007 may
affect you, please consult an attorney prior to applying for your marriage license.
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MARRIAGE LICENSE APPLICATION (Kern County Clerk)

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Completed 3 April 2021

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