COUNTY CLERK / ELECTIONS
701 OCEAN STREET, ROOM 210, SANTA CRUZ, CA 95060-4076 831-454-2060 (Elections) 831-454-2470 (County Clerk) TOLL-FREE: 866-282-5900 FAX: 831 454-2445 TDD: 831-454-2123 E-MAIL: gail.pellerin@co.santa-cruz.ca.us Web Sites: www.sccoclerk.com and www.votescount.com
GAIL L. PELLERIN, COUNTY CLERK
TO OBTAIN A CERTIFIED COPY OF A CONFIDENTIAL MARRIAGE LICENSE
To Whom it May Concern: In order for our office to satisfy your request for a certified copy of your Confidential Marriage License You will have to apply in one of the two ways: 1. One party to the marriage has to appear at this office and produce a current and valid photo ID (e.g., Driver’s License, valid passport, etc.) Personally appear before a notary public and after producing proper identification, have the notary complete side two of the attached form.
2.
The fee for each certified copy of a Confidential Marriage License is $15.00, made payable to “County Clerk”. A self-addressed stamped envelope (SASE) is strongly suggested, in order to receive your certified copy as soon your request is processed.
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APPLICATION FOR CERTIFIED COPY OF CONFIDENTIAL MARRIAGE CERTIFICATE ISSUED IN SANTA CRUZ COUNTY
Confidential marriage certificates are filed in the same county in which they were issued. If you did not obtain your confidential marriage certificate from Santa Cruz County, we will not be able to obtain a copy. You must apply with the county in which it was issued and filed. Copies of Public Marriage Licenses may be obtained online through www.vitalcheck.com MAIL REQUESTS TO: Include Signed Application Notary Acknowledgment & Fee SANTA CRUZ COUNTY CLERK 701 OCEAN STREET, ROOM 210 SANTA CRUZ, CA 95060 831-454-2060 / FAX: 831-454-2445
FEE:
$15.00 each / Check or money order made payable to the Santa Cruz County Clerk Please include a self-addressed stamped envelope with your request.
Names on Marriage License 1st Person’s Name: ______________________________________________________
First Name LAST NAME used when Marriage License was obtained
2nd Person’s Name: ______________________________________________________
First Name LAST NAME used when Marriage License was obtained
Date of Marriage: _____ / ______ / _________
# of copies: ______________
mm
Mail certified copy to:
dd
Name
YYYY
__________________________________________ __________________________________________
Address
__________________________________________
City State Zip
NOTE: THIS APPLICATION MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC!!
I request a certified copy of my Confidential Marriage Certificate as set forth above.
Signature of applicant: ________________________________ Date: __________________ Printed Name: _______________________________________
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NOTARY ACKNOWLEDGMENT
State of ______________________________ County of _____________________________
On _________________________ before me, _______________________________________ (insert name and title of the officer) personally appeared _________________________________________________________, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature ______________________________
(Seal)