Virginia Marriage certificate application form

SPOUSE 1 NAME AND INFORMATION

SPOUSE FIRST NAME

SPOUSE MIDDLE NAME

SPOUSE LAST NAME AT TIME OF THE EVENT (BEFORE MARRIAGE)

SUFFIX

HAS SPOUSE CHANGED HER/HIS LAST NAME BEFORE OR AFTER THE EVENT?

Yes

SPOUSE DATE OF BIRTH

GENDER

Male

Female

SPOUSE 2 NAME AND INFORMATION

SPOUSE FIRST NAME

SPOUSE MIDDLE NAME

SPOUSE LAST NAME AT TIME OF THE EVENT (BEFORE MARRIAGE)

SUFFIX

HAS SPOUSE CHANGED HER/HIS LAST NAME BEFORE OR AFTER THE EVENT?

Yes

SPOUSE DATE OF BIRTH

GENDER

Male

Female

YOUR NAME AND CONTACT INFORMATION

Please enter your name and contact information here.

FIRST NAME

MIDDLE NAME

LAST NAME

PHONE NUMBER

EMAIL ADDRESS

CONFIRM EMAIL ADDRESS

RELATIONSHIP TO THE PERSON ON RECORD

WHAT IS YOUR RELATIONSHIP WITH THE PERSON ON THE CERTIFICATE?

WHY ARE YOU APPLYING FOR A MARRIAGE CERTIFICATE?

ADDRESS WHERE YOU WOULD LIKE THE MARRIAGE CERTIFICATE TO BE DELIVERED

STREET

APT, SUITE, FLOOR, ETC.

CITY

STATE

ZIP CODE

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 birth 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.

MARRIAGE INFORMATION

SPOUSE 1 NAME AND INFORMATION

SPOUSE 2 NAME AND INFORMATION

YOUR NAME AND CONTACT INFORMATION

RELATIONSHIP TO THE PERSON ON RECORD

ADDRESS WHERE YOU WOULD LIKE THE MARRIAGE CERTIFICATE TO BE DELIVERED