"Application for Certified Copy of a Confidential Marriage Certificate" - Alameda County, California

Application for Certified Copy of a Confidential Marriage Certificate is a legal document that was released by the Clerk-Recorder Office - Alameda County, California - a government authority operating within California. The form may be used strictly within Alameda County.

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INSTRUCTIONS TO COMPLETE APPLICATION FOR CERTIFIED COPY
OF A CONFIDENTIAL MARRIAGE CERTIFICATE - $17.00 PER COPY IN ALAMEDA COUNTY
Marriage Certificate Information:
1
Print or type number of copies requested.
Print or type party A / name of groom.
Print or type party B / name of bride as shown on marriage license.
Print or type date of marriage.
Print or type city where license was purchased.
Applicant Information:
2
GF
If you ordered online at the Alameda County website, please include the 13-digit Order Confirmation Number.
GF
Print or type name of person ordering copy.
Print or type street address where copy is to be delivered.
We may need to contact you regarding your certificate order.
Print or type telephone number of person ordering copy, including area code.
Print or type email address.
3
Family Code Section 509 permits a party to a confidential marriage to obtain a certified copy of the confidential
marriage certificate “By personally appearing before a notary public…producing proper identification, obtaining a
certificate attesting to the party’s identity…and transmitting the certificate, together with a request for the certified
copy of the confidential marriage certificate, to the county clerk of the county with which the certificate is filed.”
Identify if you are a party to the Marriage (Groom/Bride) or (Party A/B) or entitled as a result of court order, by
checking one box.
Family Code Section 511(a) except as provided in subdivision (b), the county clerk shall maintain confidential
marriage certificates filed pursuant to Section 506 as permanent records which shall not be open to public inspection
except upon order of the court issued upon a showing of good cause. The confidential marriage license is a
confidential record and not open to public inspection without an order from the court.
4
DO NOT COMPLETE THIS PART UNTIL YOU ARE IN THE PRESENCE OF THE NOTARY PUBLIC WHO WILL
PREPARE THE CERTIFICATE OF ACKNOWLEDGMENT IN ITEM 5.
Certificate of Acknowledgment
5
Complete Items 1 through 3 on this application, then take this form to a notary public. Complete and sign the sworn
statement in Item 4 in the presence of the notary public. Request that the notary acknowledge your signature in the
sworn statement in Item 4. Mail the original application, with Sections 4 and 5 completed, and the appropriate fee, to:
Alameda County Clerk-Recorder
1106 Madison Street
Oakland, CA 94607
You may also fax the notarized statement to the office of the Alameda County Clerk-Recorder at 510 208-9957.
J:\RECDOCS\New Clerk-Recorder Form Inventory\2015\Vitals & GB
INSTRUCTIONS TO COMPLETE APPLICATION FOR CERTIFIED COPY
OF A CONFIDENTIAL MARRIAGE CERTIFICATE - $17.00 PER COPY IN ALAMEDA COUNTY
Marriage Certificate Information:
1
Print or type number of copies requested.
Print or type party A / name of groom.
Print or type party B / name of bride as shown on marriage license.
Print or type date of marriage.
Print or type city where license was purchased.
Applicant Information:
2
GF
If you ordered online at the Alameda County website, please include the 13-digit Order Confirmation Number.
GF
Print or type name of person ordering copy.
Print or type street address where copy is to be delivered.
We may need to contact you regarding your certificate order.
Print or type telephone number of person ordering copy, including area code.
Print or type email address.
3
Family Code Section 509 permits a party to a confidential marriage to obtain a certified copy of the confidential
marriage certificate “By personally appearing before a notary public…producing proper identification, obtaining a
certificate attesting to the party’s identity…and transmitting the certificate, together with a request for the certified
copy of the confidential marriage certificate, to the county clerk of the county with which the certificate is filed.”
Identify if you are a party to the Marriage (Groom/Bride) or (Party A/B) or entitled as a result of court order, by
checking one box.
Family Code Section 511(a) except as provided in subdivision (b), the county clerk shall maintain confidential
marriage certificates filed pursuant to Section 506 as permanent records which shall not be open to public inspection
except upon order of the court issued upon a showing of good cause. The confidential marriage license is a
confidential record and not open to public inspection without an order from the court.
4
DO NOT COMPLETE THIS PART UNTIL YOU ARE IN THE PRESENCE OF THE NOTARY PUBLIC WHO WILL
PREPARE THE CERTIFICATE OF ACKNOWLEDGMENT IN ITEM 5.
Certificate of Acknowledgment
5
Complete Items 1 through 3 on this application, then take this form to a notary public. Complete and sign the sworn
statement in Item 4 in the presence of the notary public. Request that the notary acknowledge your signature in the
sworn statement in Item 4. Mail the original application, with Sections 4 and 5 completed, and the appropriate fee, to:
Alameda County Clerk-Recorder
1106 Madison Street
Oakland, CA 94607
You may also fax the notarized statement to the office of the Alameda County Clerk-Recorder at 510 208-9957.
J:\RECDOCS\New Clerk-Recorder Form Inventory\2015\Vitals & GB
APPLICATION FOR CERTIFIED COPY OF A CONFIDENTIAL MARRIAGE
CERTIFICATE - $17.00 PER COPY IN ALAMEDA COUNTY
Marriage Certificate Information
Number of copies requested: ____________
1
Name of Party A: ________________________________________________________________________________________
Last (Before Marriage)
First
Name of Party B: ________________________________________________________________________________________
Last (Before Marriage)
First
Date of Marriage: ________________________ City Where License was Purchased:__________________________________
Month/Day/Year
Applicant Information
(If ordered online) Confirmation #: _____________________
2
Last Name: ________________________________________ First Name: ________________________________________
GF
GF
Home Address: __________________________________________________________________________________________
(P.O. Box not acceptable) Number and Street (APT #)
City
State
Zip Code
Shipping Address: _______________________________________________________________________________________
(If Different than home)
Number and Street (APT #)
City
State
Zip Code
Telephone Number: _(_____)___________________________Email Address: _______________________________________
Certified copies of Confidential Marriage Certificates may be obtained only by a party to the marriage or by
3
court order. Requests made by any other person or agency will not be honored.
Authority to Request a Copy (Check One):
Party to the Marriage (Groom/Bride or Party A / B)
o
Court Order (Please include a copy of the court order)
o
I, ________________________________________________, swear under penalty of perjury that I am an authorized person, as
4
(Print Your Name)
defined in California Health and Safety Code Section 103526 (c), and am eligible to receive a certified copy of the marriage
record identified on this application form. Sworn this __________________ day of _________________________, 20________,
at ______________________________________________
Signature: ___________________________________________
(City and State)
Acknowledgment
5
A notary public or other officer completing this certificate verifies only the
State of ________________________
identity of the individual who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or validity of that document.
County of _______________________
On ____________ before me, __________________________________________________, personally appeared
(name and title of the officer)
____________________________ who proved to me on the basis of satisfactory evidence to be the person whose
name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her
authorized capacity, and that by his/her signature on the instrument the person, or the entity on behalf of which the
person 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 of Notary Public
(Notary Seal)
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