Leicester City Council Duplicate Marriage Certificate Application Form

For office use only

APPLICATION REF NO: Register No.

Entry No.

Certificate No.

APPLICATION FOR A MARRIAGE CERTIFICATE Your full name Your full postal address

Relationship to people named below

Reason for applying for certificate

Details of the Marriage certificate required Full name of bridegroom

Forename(s)

Surname

Forename(s)

Surname

(on wedding day)

Full name of bride (on wedding day)

Date of marriage E.g. Name of Register Office / Religious building / Civil marriage venue

Place of marriage Any other names used by bridegroom

(N.B. GRO reference is not sufficient in itself) Forename(s)

Surname

Forename(s)

Surname

(prior to wedding day)

Any other names used by bride (prior to wedding day)

I require …….. Standard Marriage certificate(s) at £7.00 each = I enclose a cheque / postal order / sterling bankers draft / sterling money order for the sum of made payable to “Leicester City Council”. Signature of applicant Date of application Post to: Register Office, Town Hall, Town Hall Square, Leicester LE1 9BG