Fillable Printable Marriage and Divorce Verification - California
Fillable Printable Marriage and Divorce Verification - California
Marriage and Divorce Verification - California
MAN
SECTION A. MARRIAGE VERIFICATION
SECTION B. DIVORCE VERIFICATION
INSTRUCTIONS:
For Marriage Verification, complete SECTION A, for Divorce Verification, complete SECTION B. Please return this form in the enclosed
envelope to the office checked above.
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT
OF SOCIAL SERVICES
PLEASE SEND ANY REPLY TO:
Will you please verify:
■■ the marriage of _________________________________________ and ____________________________________________________
said to have taken place on _______________________________ at _____________________________________________________
■■ the divorce of __________________________________________ and ____________________________________________________
DATE OF MARRIAGE:
SIGNED: TITLE: DA TE
A. NAME ON CERTIFICATE
B. AGE
C. NUMBER OF PREVIOUS
MARRIAGES NOTED
REGISTERED NO: PLACE OF MARRIAGE:
WOMAN
RECORD SHOWS MARRIAGE
OCCURRED ON: (
SPECIFY DATE
)
AT: (
CITY/COUNTY/STATE
)
PLACE DIVORCE COMPLAINT FILED: DATE OF INTERLOCUTORY DECREE: DATE OF FINAL DECREE:
AGES OF MINOR CHILDREN:
DATE DIVORCE COMPLAINT FILED:
GROUNDS ON WHICH DIVORCE SECURED.
NAMES OF CHILDREN:
TO WHOM WAS CUSTODY OF EACH GIVEN:
SUPPORT ORDERED:
NAME OF PLAINTIFF:
SIGNED:
TITLE: DATE:
AD 8 (10/01) (COMBINED WITH AD 19 – MARRIAGE/DIVORCE VERIFICATION)
