Form ACCCMC "Application for Certified Copy of Confidential Marriage Certificate" - City and County of San Francisco, California

What Is Form ACCCMC?

This is a legal form that was released by the Office of the County Clerk - City and County of San Francisco, California - a government authority operating within California. The form may be used strictly within City and County of San Francisco. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2016;
  • The latest edition provided by the Office of the County Clerk - City and County of San Francisco, California;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form ACCCMC by clicking the link below or browse more documents and templates provided by the Office of the County Clerk - City and County of San Francisco, California.

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Download Form ACCCMC "Application for Certified Copy of Confidential Marriage Certificate" - City and County of San Francisco, California

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City & County of San Francisco
Office of the County Clerk
APPLICATION FOR CERTIFIED COPY OF CONFIDENTIAL MARRIAGE CERTIFICATE
Certified copies of PUBLIC marriage licenses are issued by the Assessor-Recorder’s Office located at City Hall, Room 190, 1 Dr. Carlton B. Goodlett
Place, San Francisco, CA 94102-4698. Phone: (415) 554-5596.
The County Clerk’s Office only has records of CONFIDENTIAL marriage certificates ISSUED IN SAN FRANCISCO. Copies will be made available 10
BUSINESS DAYS AFTER THE LICENSE HAS BEEN RECEIVED FOR REGISTRATION. These copies are only available to the named parties on the license.
Acceptable I.D. must be presented at the time of your request. Please indicate the type of certified copy you are requesting:
I am one of the parties to the confidential marriage
I am a party entitled to receive the record as a result of a court order
(include a certified copy of the court order with this request)
Those who are not authorized by law to receive a certified copy of a confidential marriage record will receive a letter confirming the existence of a
confidential marriage pursuant to Family Code Section 511(c).
Fee:
$15 per copy (payable to SF County Clerk). PLEASE SUBMIT A CHECK (FROM AN USA ISSUED BANK, NO FOREIGN CHECKS), MONEY ORDER, OR
CASHIER’S CHECK - DO NOT SEND CASH (Not responsible for fees paid in cash that are lost, misdirected, or undelivered). If no record is found,
the $15 fee will be retained for searching for the record (as required by law) and a “Certificate of No Record” will be issued to the applicant.
There are absolutely NO refunds.
Mail application and a (large) self-addressed stamped return envelope to: SF County Clerk, City Hall #168, San Francisco, CA 94102
APPLICANT INFORMATION (PLEASE PRINT OR TYPE)
Today’s Date:
Agency Name (if appropriate)
Agency Case No
Purpose of Request
.
Print Name of Applicant
Signature of Applicant
Amount Enclosed
Number of Copies
Mailing Address – Number, Street
DO NOT SEND CASH
$
City
Email Address
State/Province
ZIP Code
Daytime Telephone (include area code)
(
)
MARRIAGE RECORD INFORMATION (PLEASE PRINT OR TYPE)
Date of Marriage
County Issued: SAN FRANCISCO
Was the record amended? ___Yes
___No
(MM/DD/CCYY)
FIRST Name of First Person
MIDDLE Name
Last Name as listed on marriage certificate
FIRST Name of Second Person
MIDDLE Name
Last Name as listed on marriage certificate
---------------------------------------------------------------------SWORN STATEMENT---------------------------------------------------------------------
I, ____________________________________________________, declare under penalty of perjury under the laws of the State of California,
(Printed Name)
that I am an authorized person, as defined in California Health and Safety Code Section 103526 (c)(1) and Family Code Section 509(a), and am
eligible to receive a certified copy of the marriage certificate of the following individual(s):
Name of Both Parties Listed on the Marriage Certificate
Your Relationship to the Parties Listed on the Marriage Certificate
--------------------(The remaining information must be completed in the presence of a Notary Public or County Clerk staff.)--------------------
Note: If submitting your order in person, you must sign this in the presence of County Clerk staff. If submitting your order by mail, you must have
your signature on the Sworn Statement acknowledged by a Notary Public using a Certificate of Acknowledgment (provided by the notary public)*.
*Acknowledgements executed by Notaries Public outside of USA are not accepted. Sworn Statement must be taken before an Embassador, Minister,
Consul, Vice Consul, or Consular Agent of the United States, or before any Judge of a Court of record having a seal in such foreign country. (CA CCP
2014)
Subscribed to this __________ day of ___________________, 20___, at _________________________, ________________.
(Day)
(Month)
(City)
(State)
___________________________________________________
(Signature of person requesting certified copy)
ISSUE DATE – MONTH,DAY,YEAR
LRN
OTHER/# COPIES
BANKNOTE NUMBER
RECEIPT NUMBER
BY:
DEPUTY
___________________________________________________________________________________________________________________________
CONFIDENTIAL MARRIAGE
ACCCMC (01/2016)
City & County of San Francisco
Office of the County Clerk
APPLICATION FOR CERTIFIED COPY OF CONFIDENTIAL MARRIAGE CERTIFICATE
Certified copies of PUBLIC marriage licenses are issued by the Assessor-Recorder’s Office located at City Hall, Room 190, 1 Dr. Carlton B. Goodlett
Place, San Francisco, CA 94102-4698. Phone: (415) 554-5596.
The County Clerk’s Office only has records of CONFIDENTIAL marriage certificates ISSUED IN SAN FRANCISCO. Copies will be made available 10
BUSINESS DAYS AFTER THE LICENSE HAS BEEN RECEIVED FOR REGISTRATION. These copies are only available to the named parties on the license.
Acceptable I.D. must be presented at the time of your request. Please indicate the type of certified copy you are requesting:
I am one of the parties to the confidential marriage
I am a party entitled to receive the record as a result of a court order
(include a certified copy of the court order with this request)
Those who are not authorized by law to receive a certified copy of a confidential marriage record will receive a letter confirming the existence of a
confidential marriage pursuant to Family Code Section 511(c).
Fee:
$15 per copy (payable to SF County Clerk). PLEASE SUBMIT A CHECK (FROM AN USA ISSUED BANK, NO FOREIGN CHECKS), MONEY ORDER, OR
CASHIER’S CHECK - DO NOT SEND CASH (Not responsible for fees paid in cash that are lost, misdirected, or undelivered). If no record is found,
the $15 fee will be retained for searching for the record (as required by law) and a “Certificate of No Record” will be issued to the applicant.
There are absolutely NO refunds.
Mail application and a (large) self-addressed stamped return envelope to: SF County Clerk, City Hall #168, San Francisco, CA 94102
APPLICANT INFORMATION (PLEASE PRINT OR TYPE)
Today’s Date:
Agency Name (if appropriate)
Agency Case No
Purpose of Request
.
Print Name of Applicant
Signature of Applicant
Amount Enclosed
Number of Copies
Mailing Address – Number, Street
DO NOT SEND CASH
$
City
Email Address
State/Province
ZIP Code
Daytime Telephone (include area code)
(
)
MARRIAGE RECORD INFORMATION (PLEASE PRINT OR TYPE)
Date of Marriage
County Issued: SAN FRANCISCO
Was the record amended? ___Yes
___No
(MM/DD/CCYY)
FIRST Name of First Person
MIDDLE Name
Last Name as listed on marriage certificate
FIRST Name of Second Person
MIDDLE Name
Last Name as listed on marriage certificate
---------------------------------------------------------------------SWORN STATEMENT---------------------------------------------------------------------
I, ____________________________________________________, declare under penalty of perjury under the laws of the State of California,
(Printed Name)
that I am an authorized person, as defined in California Health and Safety Code Section 103526 (c)(1) and Family Code Section 509(a), and am
eligible to receive a certified copy of the marriage certificate of the following individual(s):
Name of Both Parties Listed on the Marriage Certificate
Your Relationship to the Parties Listed on the Marriage Certificate
--------------------(The remaining information must be completed in the presence of a Notary Public or County Clerk staff.)--------------------
Note: If submitting your order in person, you must sign this in the presence of County Clerk staff. If submitting your order by mail, you must have
your signature on the Sworn Statement acknowledged by a Notary Public using a Certificate of Acknowledgment (provided by the notary public)*.
*Acknowledgements executed by Notaries Public outside of USA are not accepted. Sworn Statement must be taken before an Embassador, Minister,
Consul, Vice Consul, or Consular Agent of the United States, or before any Judge of a Court of record having a seal in such foreign country. (CA CCP
2014)
Subscribed to this __________ day of ___________________, 20___, at _________________________, ________________.
(Day)
(Month)
(City)
(State)
___________________________________________________
(Signature of person requesting certified copy)
ISSUE DATE – MONTH,DAY,YEAR
LRN
OTHER/# COPIES
BANKNOTE NUMBER
RECEIPT NUMBER
BY:
DEPUTY
___________________________________________________________________________________________________________________________
CONFIDENTIAL MARRIAGE
ACCCMC (01/2016)