MARRIAGE LICENSE ISSUANCE
The Town of Chester Town Clerk is issuing marriage licenses in person,
by appointment, for couples getting married in the State of New York within 60 days.
Please fill out the questionnaire below and attach it to an email to: lzappala@thetownofchester.org,
along with copies of the following documents: original or certified birth certificates,
current form of I.D., such as driver’s license or passport, original or certified copies of divorce decrees,
if applicable. All documents must be in English or be accompanied by a certified English translation.
Once reviewed, an appointment with be set up for both of you to come in to complete the license.
The fee is $40, payable by cash, check or credit card.
QUESTIONNAIRE
PLANNED WEDDING DATE: _______________________CONTACT PHONE: ____________________________________
PARTY 1 PARTY 2
Current Legal Name_____________________________ Current Legal Name____________________________________
Current Address________________________________ Current Address_______________________________________
Birth Name____________________________________ Birth Name___________________________________________
Birth Date_____________________________________ Birth Date____________________________________________
Birth Place (City, State) ___________________________Birth Place (City, State)_________________________________
Mother’s Maiden Name & Country of birth: Mother’s Maiden Name & Country of birth:
____________________________________________ ___________________________________________________
Father’s Name & Country of birth: Father’s Name & Country of birth:
____________________________________________ ___________________________________________________
Name after Marriage____________________________ Name after Marriage___________________________________
Social Security #_________________________________Social Security #_______________________________________
Occupation/Industry_____________________________Occupation/Industry___________________________________
