Application For Certified Copy Of Marriage Certificate Issued In Holt County

 

 

PLEASE TYPE OR PRINT LEGIBLY

 

Full name of groom_______________________________________________________

 

Full maiden name of bride__________________________________________________

(Please list any other name bride may have used)

 

Month, day, and year of marriage_____________________________________________

 

For what purpose is this record to be used?_____________________________________

 

If this is not your marriage record, how are you related to the persons listed on the record?__________________________________________________________________

 


WARNING:  Section 71-649, Nebraska Revised Statutes:  It is a felony to obtain,  possess, use, sell, furnish, or
attempt to obtain any vital record for purpose of deception.