Application for Copy of a Document from
Date: ________________
Name
or Names on document being copied:
Type of Document you are requesting a copy of?
Service Discharge, Marriage License, Deed, etc.
Reason you need this copy________________________
Relationship to person or persons named on document?
Your Full Name_________________________________
Address_________________________________
City, State, ZIP__________________________________
Phone #__________________________________
Signature__________________________________
Attach a copy of State or Federally issued ID if the document you are requesting contains personal information (see instructions on next page.)
_______________________________________________________________________________
BELOW THIS SPACE IS FOR COUNTY CLERK’S OFFICE USE ONLY
Clerks Signature_____________________________________________
Clerks Printed Name__________________________________________
Date completed/mailed_________________________________________
INSTRUCTIONS:
Please fill out the information on the previous page. If you have a volume and page reference, you may include that under Name or Names on document being copied.
We only need the Reason you need this copy, Relationship to person or persons named on document and your State of Federally issued ID if the document you are requesting has personal information on it (dates of birth, Social Security Numbers, etc.) Due to identity theft issues, we are now keeping track of who obtains copies of these documents.
Please see the fee pages on our website for the current cost of copies.
Do not use this form for requesting a copy of a birth or death certificate. There is a separate form for birth, and a separate form for death certificates on the forms page of our website.
You may mail this request along with payment to the following address: