700-00196 – Petition for Correction or Amendment of Marriage Record (07/2018) Page 1 of 1
PETITION FOR CORRECTION OR AMENDMENT OF MARRIAGE RECORD
Petitioners, ____________________________________ spouses, of __________________________________
in the County of ________________________ and State of Vermont, and represent that they were married
on the __________________ day of __________ at _______________________________________ in the
County of ________________________ and State of Vermont.
That the marriage license was issued by the Town/City Clerk of _________________________ County of
_________________________ and State of Vermont and that the record of marriage appears in the records
of the Town/City Clerk’s office of the Town/City of _________________________ County of
_________________________ and State of Vermont (a copy of which is hereto attached) and the said record
is erroneous as to the following facts:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
The erroneous facts in said record should correctly appear as follows:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
WHEREFORE, your petitioners ask the Court, after due notice and hearing, find that facts with respect to
the Record of Marriage of your petitioners, issue a decree setting forth the facts found and fill out a
corrected or amended Certificate of Marriage in the usual form, and file such certificate with the
Town/City Clerk of the Town/City of ________________________, County ________________________
State of Vermont.
Dated
_____________________________ _____________________________________
Signature
_____________________________________
Printed Name
_____________________________________
_____________________________________
Address
_____________________________________
Telephone