Office of John F. Warren County Clerk Dallas County, Texas www.DallasCounty.org CERTIFIED COPY OF MARRIAGE RECORD REQUEST (Copias de licencia de matrimonio) FEES AND INFORMATION Certified Marriage Records are $10.00 per copy CASH, MONEY ORDER, or DEBIT/CREDIT in person (A $3.95 charge will be added for Debit/Credit) MONEY ORDER ONLY by mail Non-refundable fee of $10.00 for searched requests COSTO Y INFORMACION Copias Certificada son $10.00 por licencia EFFECTIVO, MONEY ORDER, Y CREDITO/DEBIT in persona. ($3.95 mas para Debit/Credito) SOLO MONEY ORDEN por correo No regresamos fondos por servicio ***MARRIAGE RECORD INFORMATION*** DALLAS COUNTY ONLY Date of Marriage: (Fecha de matrimonio) [# ] Copies Requested Month/Mes de matrimonio Day/Dia de matrimonio Year/Año de matrimonio First/Primer Nombre Middle/Segundo Last Name/Appellido First/Primer Nombre Middle/Segundo Maiden Last Name/Appellido de Soltera Marriage Applicant 1 (Aplicante 1) Marriage Applicant 2 (Aplicante 2) Other Last Name/Apellido Anterior ***YOUR INFORMATION*** Your relationship to above record (Informacion de solicitante) [ ] Spouse [ ] Officiant [ ] Single Status [ ] Other Name: (Nombre) First/Primer nombre de solicitante Home address: # Street/Calle (Domicilio) Phone #: (Telefono) Middle/Segundo ( ) [ ] SAME AS ABOVE Mailing address if different from above: (Residencia de domicilio es diferente) Apt # City/Ciudad Zip/Codigo (for Receipt): First/Primer nombre (Must sign to process) Apt # Date Middle/Segundo City/Ciudad Last/Apellido State/Estado Zip/Codigo Would you like a paper receipt? YES NO Would you like a receipt emailed? YES NO Mail your form and money order to: (Please allow 2-4 weeks to process by mail) State/Estado E-mail # Street/Calle Dallas County Clerk’s Office ATTN: Marriage License 509 Main Street Suite #200 Dallas, TX 75202 Last Name/Appellido OFFICE USE ONLY Issuing Clerk Amount Receipt License # Year Volume Page Form revised 02/02/2015 DCCYAWOT