Application For License And Certificate Of Marriage printable pdf download

APPLICATION FOR LICENSE AND CERTIFICATE OF MARRIAGE

PLEASE READ BEFORE COMPLETING APPLICATION



When you sign the marriage application form, you are stating under penalty of perjury that the information you have provided

is true and correct, that you are currently an unmarried couple, and that there is no legal objection to the marriage.



The marriage license must be used within the State of California. Check the license to see what the requirements are for

witnesses and solemnization.



Marriage licenses are valid for 90 days from the date of issuance. You must be married on or after the issuance date, and on

or before the expiration date of the license. Licenses not used within this timeframe are void.



The appropriate fee may be paid in cash or by check, payable to the county clerk.



No refunds are given for marriage licenses purchased in error.



Please check the type of marriage license you would like to apply for:

License and Certificate of Marriage (VS 117) — This is the standard type of marriage license. This type of

marriage license requires the signature of at least one witness and one person solemnizing the marriage.

License and Certificate of Marriage for Denominations Not Having Clergy (VS 115) — This type of license is

used for the recording of marriages for members of religious societies or denominations that do not have clergy for

the purpose of solemnizing a marriage.

License and Certificate of Declaration of Marriage (VS 116) — This type of license is used for the recording of a

marriage that was licensed and occurred over one year ago; however, no official record exists.

Confidential License and Certificate of Marriage (VS 123) — Confidential marriage licenses may only be issued to

unmarried parties who are at least 18 years old and have been living together as spouses. Since the confidential

marriage license requires the signature of a marriage officiant, they are not available to members of religious

denominations not having clergy. Certified copies of the marriage license and certificate may only be issued to the

couple. Confidential marriage licenses may not be available in all counties. The signatures of the parties in fields 23

and 24 affirm that they meet the requirements to receive a confidential marriage license.

INFORMATION REGARDING THE NAME EQUALITY ACT OF 2007

The Name Equality Act of 2007 (AB 102, Chapter 567, Statutes of 2007) allows one or both applicants to a California marriage

to elect to change the middle or last names by which each party wishes to be known after they are married by entering the

new name in fields 29A thru 30C, as applicable, on the marriage license application. This must be done at the time the

applicants are applying for the marriage license. Each party to the marriage may adopt any of the following middle or last

names (Family Code Section 306.5(b)(2)):



Current last name of the other spouse



Last name of either spouse given at birth



A name combining into a single last name all or a segment of the current last name or the last name of either

spouse given at birth



A hyphenated combination of last names

NOTE: Parties to the marriage may not change their first name on the marriage license.

Parties to the marriage are not required to change their name, nor, are they required to have the same name.

If one or both parties do not wish to identify a new name on the marriage license, the fields on the marriage license

will be completed using two single dashes. You may not change the information on the marriage license after it has

been issued by the County Clerk, unless there is a clerical error.

The marriage certificate is used by multiple local, state, federal and private agencies, each of which have different

requirements regarding what documents are acceptable to change your name on their records following marriage. It is

recommended that you contact these agencies to verify their requirements prior to applying for your marriage license.

County Clerk staff cannot provide you information on how to complete the marriage license application as it relates to the entry

of a new name or retention of your former name on the marriage license application. For your protection, if you have any

questions regarding whether you should or should not list your new name on the marriage license application, and/or how the

Name Equality Act of 2007 may affect you, please consult with a private attorney prior to applying for your marriage

license.

CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - VITAL RECORDS

VS117Be (01/2015)

Application For License And Certificate Of Marriage

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