Marriage License Application

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TO APPLICANT FOR MARRIAGE LICENSE: By law, each applicant is required to furnish the County Clerk the following information before a license may be issued (Please PRINT or TYPE): At least one of the applicants must apply in person. Photo ID or birth certificate is required for both applicants. State of Michigan resident fee $20.00. Out of state resident fee $30.00

MALE		FEMALE

Full name of male (first, middle, last)		Full name of female (first, middle, last)

		Female's maiden name before first married, if different

Street address		Street address

City, State and Zip Code		City, State and Zip Code

Residence County	Social Security #	Residence County	Social Security #

Present Age	Date of Birth	Present Age	Date of Birth

Times Previously Married		Times Previously Married

Birthplace - City and State		Birthplace - City and State

Father's Full Name		Father's Full Name

Father's State of Birth (or Country if not USA)		Father's State of Birth (or Country if not USA)

Mother's Full Maiden Name Before First Married		Mother's Full Maiden Name Before First Married

Mother's State of Birth (or Country if not USA)		Mother's State of Birth (or Country if not USA)

YOUR MARRIAGE RECORD IS VITAL TO YOU. BE SURE THE FOREGOING IS COMPLETE AND CORRECT.

County Clerk