Kentucky Application for a Certified Copy of Marriage/Divorce Certificate Form
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COMMONWEALTH OF KENTUCKY
STATE REGISTRAR OF VITAL STATISTICS
APPLICATION FOR A CERTIFIED COPY OF MARRIAGE/DIVORCE CERTIFICATE
Please Print or Type All Information Required On This Form
MARRIAGE/DIVORCE CERTIFICATE INFORMATION
1. Full Name of
2. Maiden Name of Wife
3. County in Which
4. Date of Marriage
5. County in Which
6. Date of Divorce
Signature and telephone number of the person requesting this certificate:
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