Fillable Printable Application for Certified Copy of Marriage License - Maryland

Application for Certified Copy of Marriage License - Maryland

Circuit Court for Harford County

20 W. Courtland St.

Bel Air, MD 21014

Request for Certified Copy of Marriage License

A Certified Copy of a Marriage License is legal documentation of a marriage. Certified copies may be required to change

your name with the MVA, Social Security Administration, Passports, Insurance Companies, etc.

NOTE: Certified copies are $5.50 per copy. Effective 1/ 1/ 2015: Additional $2.00 m ail handling fee per

request. Acceptable form s of paym ent are cash, m oney orders or cashier checks (payable to the Clerk of

the Court), and M astercard or Visa.

You may apply in person, by mail, via email, phone or fax request.

For credit card payments:

Please complete: ____ MC or ____ Visa (check one). Credit Card Account # _________________________________

Cardholder’s name: ____________________________________________

Expiration date: ______________

I hereby authorize payment by credit card (signature required).

________________________________________________

Cardholder’s Signature

PLEASE P RINT REQUI RED IN FOR MATION

Today’s Date: _____/ ______/ _________ Num ber of copies requested: _____

Party 1 Nam e: (P lease include M aiden/ Previous Last Nam e if applicable)

___________________________________________________________________________________

First Middle Last Maiden/Previous Last Name

Party 2 Nam e: (P lease include M aiden/ Previous Last Nam e if applicable)

____________________________________________________________________________________

First Middle Last Maiden/Previous Last Name

Date of M arriage: _____/ _____/ _________

Maryland M arriage License num ber (if available) _____________________________

Person/ Com pany requesting copy: ________________________________________________________

Mailing Address: ______________________________________________________________________

City/ State/ Zip Code: ___________________________________________________________________

Phone num ber: _____________________________________

Certificate # ______________________________

Harf. Cty 12.11.14