Georgia Marriage Certificate Request Form
Print out a copy, complete, and mail in your request.

MARRIAGE CERTIFICATE REQUESTS

Please indicate below the type and number of copies requested and forward this form with either a money order or certified check for the correct amount, made payable to the Georgia Department of Human Resources, Vital Records Service, 47 Trinity Avenue S.W., Room 217-H, Atlanta, Georgia 30334-1201, (404) 656-4750

[ xxxx] Full size copy $10.00 [xxxx ] Total Number of Copies Requested

Additional copies are $5.00 each at this time

NOTE: Records prior to June 9, 1952 must be requested at the Office of the Probate Judge in the
county where the license was issued. If you are requesting a marriage certificate prior to this date,
complete this application and mail it to the County's Probate Court's Office in which the marriage
was granted. Contact their office concerning their fee requirements, as their prices may differ from our prices.

Complete all information for the marriage record being requested

Groom's Name:__________________________________________________________

(first) (middle) (last)

Bride's Name:___________________________________________________________

(first) (middle) (last)

Date of Marriage:________________________________________________________

(month) (day) (year)

Place of Marriage:_______________________________________________________

(city) (county) (state)

Signature of Requestor:___________________________________________________

Relationship (if other than Bride or Groom):___________________________________

MAILING ADDRESS

List below name and address of person to whom certificate is to be mailed, then,
indicate relationship to the person whose name is on the certificate:

Name:_____________________________________ Relationship:________________

Address:_______________________________________________________________

(No. & Street or RFD and Box No.) (Apt. No.)

_____________________________________________________________

(city) (state) (zip code)