Town Clerk
Registrar of Vital Statistics
42C North Street
Goshen, Connecticut 06756
860-491-3647
_________________________________________________________
NOTE: Legal fee for vital record copies is $20.00 for each certified copy
Number of Copies _____ X $20.00/ copy = Total $ ____________**
APPLICATION FOR COPY OF MARRIAGE LICENSE
Groom’s Full Name ___________________________________________________________
(First name) (Last name)
Bride’s full maiden name ________________________________________________________________________
(First name) (Maiden name)
Date of Marriage ________________________________________________________________________
(Month) (Day) (Year)
Place of Marriage ________________________________________________________________________
______________________________________________________________________________________________________
Person Requesting this information:
Full Name: _______________________________________________________________________
Address: _______________________________________________________________________
City _________________________State______________________Zip________________
______________________________________________________________________________________________________
** Please make check payable the Goshen Town Clerk
| 
