APPLICATION FOR A MARRIAGE CERTIFICATE
APPLICATION DETAILS:
APPLICANT’S FULL NAME:....................................................................................................................................
APPLICANT’S POSTAL ADDRESS:..........................................................................................................................
.............................................................................................................................................................................
POST CODE:..........................................................................................................................................................
TELEPHONE NO:...................................................................................................................................................
DETAILS OF MARRIAGE CERTIFICATE REQUIRED:
FULL NAME Of GROOM ON DAY OF MARRIAGE:.................................................................................................
FULL NAME OF BRIDE ON DAY OF MARRIAGE (MAIDEN SURNAME PLEASE):.................................................................
.............................................................................................................................................................................
ANY OTHER SURNAMES USED BEFORE THIS MARRIAGE.....................................................................................
PLACE OF MARRIAGE, PLEASE SPECIFY (NAME OF BUILDING, CHURCH OR REGISTER OFFICE AND LOCALITY):...............................
.............................................................................................................................................................................
DATE OF MARRIAGE:...........................................................................................................................................
NO. OF CERTIFICATES REQUIRED:
1
2
3
4
5
6 (please circle)
SERVICE REQUIRED – please tick:
Priority one working day service posted first class to UK address - £17.00 each
Priority one working day service posted recorded delivery* to UK address - £18.00 each
Priority one working day service posted to an overseas address - £18.00 each
Standard five working day service posted first class to UK address - £11.00 each
Standard five working day service posted recorded delivery* to UK address - £12.00 each
Standard five working day service posted to an overseas address - £12.00 each
*Recorded delivery services require someone to be present to sign for the delivery.
Please make cheques/postal orders payable to Surrey County Council
PLEASE SELECT THE PURPOSE FOR WHICH THE CERTIFICATE IS REQUIRED:
PASSPORT APPLICATION
JOB APPLICATION/RECRUITMENT
SCHOOL APPLICATION
FAMILY HISTORY RESEARCH
LEGAL PROCEEDINGS (E.G DIVORCE, PROBATE, INSURANCES, PENSION)
ON BEHALF OF CLIENT (E.G. SOLICITOR, SOCIAL WORKER)
OTHER (PLEASE STATE)........................................................................................................................................
OFFICE USE ONLY:
DATE OF APPLICATION:............................................REFERENCE NO:....................................................
REGISTER/ENTRY NO:..............................................CERTIFICATE NO:...................................................
NOTES: