APPLICATION FOR A MARRIAGE CERTIFICATE
PLEASE READ THESE NOTES before completing this form.
Marriage Certificate
  : 142/1/211
1 TO BE COMPLETED BY THE APPLICANT
Name of applicant Mr
Mrs
Miss/Ms
(STATE NAME IN FULL)
Full postal address
 
Post Code: Telephone no: e-mail address:
2 Are you applying for your own marriage certificate? Yes/No
If not please state your relationship to the person to whom the certificate relates:
 
3 DETAILS OF MARRIAGE CERTIFICATE REQUIRED
SPOUSE PARTNER
SURNAME   SURNAME ANY OTHER SURNAME USED BEFORE THIS MARRIAGE
 
FORENAME(S)   FORENAME(S)  
DATE OF MARRIAGE PLACE OF MARRIAGE
DAY
 
MONTH
 
YEAR
 
NAME OF BUILDING, CHURCH OR REGISTER OFFICE AND LOCALITY
 
4 REQUIREMENTS Send this Application to:
MARRIAGE CERTIFICATE £10.00 Superintendent Registrar, Cheshire Central Register Office, Municipal Buildings, Earle Street, Crewe,CW1 2BJ, UK
I requireNUMBER marriage certificate(s)
5 REMITTANCE ENCLOSED  (POSTAL APPLICATIONS ONLY)
Applications should Postal order or cheque made payable to : Cheshire East Borough Council for £ 10.00 plus postage as follows: within UK £1.00 , within rest of Europe £1.50 , rest of the world £2.00
If paying by Credit Card: Please debit my account by the amount: £ Type of card
(e.g. Visa, Mastercard or Switch):
Name on Card:
 
Card Expiry Date (DD/MON/YYYY):
Enter both Card Number & Security Code. Card Number:                                       Security
Code:
     
Signature:
 
Date:

 

Card Issue No. :
(Switch only)
Card Start Date (DD/MON/YYYY):
(Switch only)
The Fee for a certificate issued against this form 'as printed' will not be refunded.
You are strongly recommended to add any qualifying information you may have in order to help the registrar issue the correct certificate.