The Application for Marriage Record and Certificate of Identity is the form the Los Angeles County Registrar-Recorder/County Clerk (RR/CC) uses to request a certified copy of a public marriage record. It asks for a copy of a record that already exists for a marriage whose license was issued in Los Angeles County, so it is not an application for a Los Angeles County marriage license. People named on the record, certain relatives and certain representatives can request an authorized copy; anyone else can request an informational copy. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the RR/CC publishes the original at lavote.gov.
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What is 76A639M?
The Application for Marriage Record and Certificate of Identity is the Los Angeles County Registrar-Recorder/County Clerk (RR/CC) form used to request a certified copy of a public marriage record, together with the Certificate of Identity used for authorized copies.
The PDF has three parts. The first page, printed as Application for Public Marriage Record, collects the date of marriage, the names of both parties as they were at birth, the county where the license was issued, your relationship to the registrants and your sworn declaration. The second part is a Special Notice to Veterans with an affidavit for a free certified copy. The last part is the Certificate of Identity/Sworn Statement, which must be signed in front of a notary, followed by a Certificate of Acknowledgement for the notary to complete. Field labels are printed in English and Spanish.
The form offers two certificate types. An authorized copy goes only to the people listed under Health and Safety Code 103526. An informational copy is available to anyone else and is imprinted "INFORMATIONAL, NOT A VALID DOCUMENT TO ESTABLISH IDENTITY" across its face.
The RR/CC can only provide copies for marriages whose license was issued in Los Angeles County, and its records go back to 1852. Confidential marriage records use a separate form, the Application for Confidential Marriage Record and Certificate of Identity. If no record is found, the RR/CC issues a "No Record Statement".
Who needs to file 76A639M?
Anyone who needs a certified copy of a public marriage record for a marriage licensed in Los Angeles County uses this form. Who receives which copy depends on the relationship to the registrants.
Authorized copy. Under Health and Safety Code 103526, as printed on the form, these people are entitled to one:
- one of the registrants, or a parent or legal guardian of one of them;
- a child, grandparent, grandchild, sibling, spouse or domestic partner of one of the registrants;
- an attorney representing one of the registrants or the registrant's estate, or any person or agency empowered by statute or appointed by a court to act for the registrant or the estate;
- a member of a law enforcement agency or a representative of another governmental agency, as provided by law, who is conducting official business.
Mail requests for authorized copies must include a notarized Certificate of Identity.
Informational copy. People who are not authorized, or who do not wish to submit the notarized Certificate of Identity, can request an informational copy. It cannot be used for legal purposes.
Veterans. A veteran or authorized agent applying for a veteran's pension or certain other Veterans Administration benefits may be eligible for a free certified copy. This does not apply to Social Security or other civilian benefits, even for a veteran.
Do not use this form for a marriage licensed outside Los Angeles County, or for a confidential marriage record.
When to file 76A639M
No deadline is printed on the form: you send it whenever you need a certified copy of a public marriage record. The RR/CC holds records for marriages whose license was issued in Los Angeles County since 1852.
After the RR/CC receives your request, the record is mailed within 20 business days from the date of receipt. If you request an authorized copy by mail and the Certificate of Identity is not notarized, the agency says the request will be delayed. A request paid with an E-check, temporary check or foreign check is rejected and sent back, which also adds time.
If you qualify for a free certified copy for veteran's benefits, complete the veterans affidavit and send it with the application. In that case the certificate is mailed to the Veteran Benefit Agency named in the affidavit.
Documents you need
- Notarized Certificate of Identity/Sworn Statement, signed in the presence of a notary, for a mail request for an authorized copy. Not needed for an informational copy.
- Check or money order payable to the Registrar-Recorder/County Clerk for the copy fee; cash, E-checks, temporary checks and most foreign checks are not accepted.
- Completed veterans affidavit (Special Notice to Veterans), only if you are requesting a free certified copy for a veteran's pension or certain other Veterans Administration benefits.
How to fill out 76A639M
Choose the certificate type
Under CERTIFICATE TYPE, mark whether you are requesting an AUTHORIZED copy or an INFORMATIONAL copy. Choose authorized only if you are one of the people listed at the top of the form.
Enter the marriage date and copies
Under Marriage Record Information, enter the Date of Marriage as Month, Day and Year, and the number of copies you want. Leave the File Number, Searched and Doubled boxes marked FOR RECORDER USE ONLY blank.
Enter both parties' names at birth
Write Name of Party A and Name of Party B, each with first, middle and last name, using the name at birth. Print legibly.
Enter the county of the license
In License issued in, enter the county. The RR/CC can only provide copies for licenses issued in Los Angeles County.
State your relationship to the registrants
In the RELATIONSHIP TO REGISTRANT(S) line, write how you are related to the registrants, using the categories listed at the top of the form.
Sign the declaration
Print your name on the "I, ____ , certify (or declare) under penalty of perjury" line, then enter the date, your signature, your DL/ID number and your phone number.
Enter your name and mailing address
Under APPLICANT NAME, STREET ADDRESS, CITY, STATE and ZIP, print the name and address where the copy should be mailed.
Complete the veterans affidavit if it applies
Only if you qualify for a free copy for veteran's benefits, enter the agency, the type of benefit, the date, the signature of the veteran or authorized agent, the agent's relationship and the agency's address.
Fill in the Certificate of Identity
Enter the name(s) on the certificate, your relationship and your printed name. Sign it only in front of a notary, who completes the Certificate of Acknowledgement.
Review, download and assemble
Check names, dates and signatures, then download or print the completed PDF from FillingPDF. Add your check or money order and mail the package as described under How to submit.
How to submit 76A639M
The RR/CC accepts this request by mail. Its marriage records page states that no requests are available by telephone.
- By mail: Registrar-Recorder/County Clerk, Birth, Death and Marriage Records Section, PO Box 489, Norwalk, CA 90651-0489.
- Payment: a fee applies, and the first copy of each record is nonrefundable. Pay by check or money order payable to the Registrar-Recorder/County Clerk. The RR/CC does not accept E-checks, temporary checks, or foreign checks (except from Canada and Mexico), and says not to send cash. For the current amount, call (800) 201-8999, the number printed on the form.
- Notarization: for an authorized copy, sign the application and the Certificate of Identity, and have the Certificate of Identity notarized. If you live outside California, tell the notary to strike out "California" and write the state where the form is notarized; the change is accepted.
- Informational copy: no notarized Certificate of Identity is needed.
FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Mailing the Certificate of Identity without a notary's acknowledgement when requesting an authorized copy; the agency says this delays the request.
- Signing the Certificate of Identity before meeting the notary, when the form requires it to be signed in the presence of a notary.
- Paying with cash, an E-check, a temporary check or a foreign check (other than Canada or Mexico); the last three cause the request to be rejected and returned.
- Using this form for a marriage whose license was issued outside Los Angeles County; the RR/CC only provides copies for certificates purchased in Los Angeles County.
- Choosing an authorized copy when you are not among the people listed under Health and Safety Code 103526; unauthorized requesters can receive only an informational copy.
- Using this public record form for a confidential marriage record, which has its own application.
- Applying for the free veterans copy for Social Security or other civilian benefits; the form says it does not apply to them.
- Living outside California and leaving "California" on the notary certificate instead of having the notary strike it out and write the state of notarization.
Frequently asked questions
Is this the form for a Los Angeles County marriage license?
No. This form requests a certified copy of a public marriage record that already exists, for a marriage whose license was issued in Los Angeles County. It is not an application for a Los Angeles County marriage license.
Who can request an authorized copy of a public marriage record?
A registrant, or a parent or legal guardian of one; a child, grandparent, grandchild, sibling, spouse or domestic partner; an attorney or court-appointed representative; or a law enforcement or government representative on official business. Others can request an informational copy.
Does the Certificate of Identity have to be notarized?
Yes for a mail request for an authorized copy. The form says it must be signed in the presence of a notary, and the RR/CC says an un-notarized certificate delays the request. Informational copies do not need it.
How long does it take to receive a marriage record copy?
The RR/CC mails the record within 20 business days from the date it receives your request. Delays can occur if the Certificate of Identity is not notarized or if payment is rejected and the request is sent back.
Is there a fee, and how do I pay?
Yes, a fee applies, and the fee for the first copy of each record is nonrefundable. Pay by check or money order payable to the Registrar-Recorder/County Clerk. Call (800) 201-8999 for the current amount; no cash, E-checks or temporary checks.
Can I get a free copy of a marriage record as a veteran?
Possibly. If you are applying for a veteran's pension or certain other Veterans Administration benefits, you may qualify by completing the affidavit on the form. It does not apply to Social Security or other civilian benefits, even if you are a veteran.
What is an informational copy of a marriage record?
It is a certified copy imprinted "INFORMATIONAL, NOT A VALID DOCUMENT TO ESTABLISH IDENTITY" across its face. Anyone who is not authorized, or who does not want to submit the notarized certificate, can request it, but it cannot be used for legal purposes.
Can I fill out this marriage record application online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF does not send the request to the county: you still mail it, with the notarized certificate and payment, to the RR/CC.
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