Fillable New York Cc2002B Form in PDF

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THE CITY OF NEW YORK

OFFICE OF THE CITY CLERK

MARRIAGE LICENSE BUREAU

MAIL REQUEST FOR MARRIAGE RECORDS

(From 1930 to present)*

NOTE: Marriage records less than fifty (50) years old will be released only:

(a)to parties to the marriage;

(b)to persons presenting written authorization from one of the parties to the marriage; or

(c)to attorneys in cases where such records are required as evidence (When making a request, attorneys, on their official stationery, must indicate the party or parties that they represent, the nature of any pending action, and make an affirmative statement that such

records are required as evidence in such proceedings.)

I solemnly swear, under penalty of perjury, that the foregoing information is true and correct and (CHECK ONE BOX ONLY)

I am a party to the marriage. (EITHER SPOUSE)

The written authorizationfrom a party to the marriage is a genuine request from such party and such party has authorized me to request and receive such records. (THIRD PARTY WITH WRITTEN AUTHORIZATION ONLY)

I am an attorney in good standing or a representative thereof and such records are required as evidence in a legal proceeding. (ATTORNEYS OR THEIR REPRESENTATIVES ONLY)

I am the spouse or prospective spouse of the above-named person and I am not divorced from such person. (SPOUSE OR PROSPECTIVE SPOUSE ONLY)

*Records from 1866 to 1929 can be obtained from the Municipal Archives, 31 ChambersStreet, Rm. 103, New York, NY 10007. Call 311 or (212) NEW YORK if outside New York

FORM CC2002B 7/12/11

INSTRUCTIONS

Complete this form. Be sure to check off the appropriate sworn statement and sign in the signature block. No request will be processed without a signed sworn statement. Enclose a photocopy of your identification. Acceptable forms of identification are: driver's license issued by any state of the USA or its territories (including learner's permit); Non-driver's identification card issued by any state of the USA or its territories; active U. S. military ID; passport; permanent resident card (green card); employment authorization card issued by the Bureau of Immigration and Customs of the Department of Homeland Security and Certificate of Naturalization issued less than ten years ago. You should copy the pages in the passport with your picture and personal information. Enclose the appropriate fee and mail to:

City Clerk of New York

141 Worth Street

New York, NY 10013

Att: Record Room

Fee Schedule: All fees are payable in advance by United States postal money order or money order/certified check drawn on a United States bank or other financial institution and payable in U.S. currency to "The City Clerk of New York." Each certified copy of a marriage certificate costs $10.00. The first one-year seach costs $5.00. A search for a second year costs an additional $1.00 and searches for any additional year after the second year cost an additional 50 cents each. For example a four year search and one certified copy would cost $17.00. Please note that the average request costs $15.00.

PLEASE NOTE THERE ARE DIFFERENT TYPES OF MARRIAGE CERTIFICATES. For instance, if you require a marriage certificate for use in a foreign jurisdiction (including obtaining a passport from a US-based foreign consulate) you need an extended form which costs $35 for the initial copy and $30 for any additional copies. For most domestic purposes, you will need a short form which costs $15 for the initial copy and $10 for any additional copies. If you are unsure of the form of marriage certificate you need, please call 311 or (212) NEW YORK if outside of New York. If you do not specify the form you desire you will be sent a short form.

******DO NOT WRITE BELOW—THIS SPACE FOR OFFICE USE ONLY******

Other:

FORM CC2002B 6/20/11