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 COSTO Y INFORMACION
 Certified Marriage Records are $10.00 per copy  Copias Certificada son $10.00 por licencia
CASH, MONEY ORDER, or DEBIT/CREDIT in person EFFECTIVO, MONEY ORDER, Y CREDITO/DEBIT in
(A $3.95 charge will be added for Debit/Credit) persona. ($3.95 mas para Debit/Credito)
 MONEY ORDER ONLY by mail  SOLO MONEY ORDEN por correo
 Non-refundable fee of $10.00 for searched requests  No regresamos fondos por servicio

***MARRIAGE RECORD INFORMATION*** [# ]

DALLAS COUNTY ONLY Copies Requested
Date of
Marriage:
(Fecha de matrimonio) Month/Mes de matrimonio Day/Dia de matrimonio Year/Año de matrimonio

Marriage
Applicant 1
(Aplicante 1) First/Primer Nombre Middle/Segundo Last Name/Appellido

Marriage
Applicant 2
(Aplicante 2) First/Primer Nombre Middle/Segundo Maiden Last Name/Appellido de Soltera

Other Last Name/Apellido Anterior

***YOUR INFORMATION*** Your relationship to [ ] Spouse [ ] Single Status

(Informacion de solicitante) above record [ ] Officiant [ ] Other
Name:
(Nombre)
First/Primer nombre de solicitante Middle/Segundo Last Name/Appellido

Home
address:
(Domicilio) # Street/Calle Apt # City/Ciudad State/Estado Zip/Codigo

Phone #: E-mail
(Telefono) ( ) (for Receipt):

[ ] SAME AS ABOVE
Mailing address if different from above:
(Residencia de domicilio es diferente) First/Primer nombre Middle/Segundo Last/Apellido

# Street/Calle Apt # City/Ciudad State/Estado Zip/Codigo

Would you like a paper receipt? YES NO

(Must sign to process) Date Would you like a receipt emailed? YES NO

Mail your form and money order to: OFFICE USE ONLY
Issuing Receipt
Dallas County Clerk’s Office Clerk
Amount

ATTN: Marriage License License #

1201 Elm St., Ste 2100
Dallas, TX 75270
(Please allow 6-8 weeks to process by mail)
Year Volume Page
Form revised 02/02/2015 DCCYAWOT