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MARRIAGE CERTIFICATE REQUESTS

You must use this form, along with the required identification materials (see below) to receive marriage certificates by mail from the Winnebago County Clerk. Print out the request form and send it along with $15.00 (1st copy) + (if needed) $4.00 (2nd copy) - (check or money order) and proper identification - to the address on the form.

                Cut along dotted lines
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                 JOHN SCHOU, County Clerk                    |
           Winnebago County Administration Bldg.             | 
                  404 Elm Street, Rm. 103                    |
                   Rockford, IL  61101                       |
                                                             |
              MARRIAGE CERTIFICATE REQUESTS                  |
                                                             |
MARRIAGE CERTIFICATE: Number of Copies _______________       |                           
                                                             |
         ***Please send copy of actual record***             |
Please Print                                                 |
                                                             |
Groom's Name______________________________________________   |
             First           Middle              Last        |
                                                             |
Bride's Name _____________________________________________   |
                                                             |
                                                             |
Date of Marriage_______________Place______________________   |
                                                             |
                                                             |
I, the undersigned, do hereby certify that I am entitled     |
to receive the above Marriage Certificate for genealogy      | 
purposes under Chap. 111 1/2 Para 73-24 of the Illinois      |
Compiled Statutes; or I am the legal representative,         |
parent, spouse, or child of the names on the marriage        |
record, and legally entitled according to the IL Compiled    |
Statutes.                                                    | 
                                                             |
                                                             |
______________________    ________________________________   |
Print Your Name                  Your Signature              |
                                                             |
______________________    ________________________________   |
Address                  Relationship to Person on Document  |
                                                             |
______________________    ________________________________   |
City                                 Phone                   |
**********************************************************   |
            THIS AREA FOR MAIL-IN ONLY                       |
                                                             |
Mail to:  Name ___________________________________________   |
                                                             |
Address___________________________________________________   |
                                                             |
City_________________________State_________Zip____________   |
                                                             |
Date Mailed:_______________Deputy:________________________   |
                                                             |
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Acceptable Identification to Receive Records

* One of the following......

* or two of the following......


[Winnebago County] [County Clerk] [Birth] [Death] [Taxes] [USGenWeb] [ILGenWeb]


Katy Hestand

County Coordinator

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This page created by Cecelia Yeruski for the ILGenWeb Project.
Last updated: Monday, 18-Apr-2005 10:03:52 MDT