Virginia Marriage certificate application form

Marriage information

1.1 Date of marriage

2.1 State of marriage

2.2 County where the marriage license was issued

2.3 City where the marriage license was issued

Spouse 1 name and information

3.1 Spouse first name

3.2 Spouse middle name

3.3 Spouse last name at time of the event

Suffix

3.4 Has Spouse changed her/his last name before or after the event?

Yes

3.7 Spouse Date of Birth

3.8 Gender

Male

Female

Spouse 2 name and information

4.1 Spouse First Name

4.2 Spouse Middle Name

4.3 Spouse last name at time of the event

Suffix

4.4 Has Spouse changed her/his last name before or after the event?

Yes

4.7 Spouse Date of Birth

4.8 Please select one of the following:

Male

Female

Your name and contact information

Whether you are seeking to apply for your marriage certificate or are submitting an application for another person (i.e. your child or spouse), please enter your name and contact information here.

5.1 First name

5.2 Middle name

5.3 Last name

5.4 Email address

5.5 Confirm email address

5.6 Phone number

Relationship to the person on record

6. What is your relationship with the person on the certificate?

7. Why are you applying for a marriage certificate?

Address where you would like the marriage certificate to be delivered

8.1 Street

8.2 Apt, suite, floor, etc.

8.3 City

8.4 State

8.5 Zip code

Agreement and Privacy Policy

By checking this box, I agree to submit the information provided to this website, and I authorize Vital Records Online to use my information to fill all necessary documents in order to prepare my application materials. I understand that VitalRecordsOnline.com is a private document preparation service and that I am hiring them to prepare my marriage certificate application materials. I understand there is a service fee charged by VitalRecordsOnline.com and I will pay the health department required fee directly by check or money order. I understand I may have to provide additional documents to the health department in order to prove my identity. By submitting the form above, I agree to these terms and the terms of this website.