Mississippi Vital Records
P.O. Box 1700
Jackson, MS 39215-1700
APPLICATION FOR CERTIFIED COPY OF STATISTICAL RECORD OF MARRIAGE
1. Marriage records have been kept by state and county officials since January 1, 1926. From July 1, 1938, to December 31, 1941, records were kept only by the circuit court clerk in the county in which the marriage license was issued.
2. The fee for a search of the records and a certified copy is $15.00. Additional copies ordered at the same time are $5.00 each.
3. A five year search of our records will be made. If the record is not on file, only fees paid for additional copies will be refunded.
4. Requirements for Ordering: If applicant is self, spouse, parent, grandparent, sibling, child, grandchild, guardian, or legal representative, then the applicant must provide a completed application and a copy of a valid photo identification of the applicant. Acceptable forms of identification are the following:
Guardian or legal representative must submit proof of guardianship/legal representation with this application. Legal representatives must provide attorney bar number, name of person represented, and their relationship to the registrant. If you are an agent of a local, state or federal agency requesting a record, indicate in the space provided for “relationship” the name of the agency.
1. Complete the required sections of this form. PLEASE PRINT.
2. The application must be signed.
Remit a personal check, bank or postal money order or a bank cashier’s check in the correct amount made payable to Mississippi State Department of Health.
We accept no responsibility for cash sent through the mail. Request for adjustments or refunds will be honored only if received within six months of application.
4. Send completed application, a copy of the required photo identification and appropriate fee to the address at the top of this form.
Please print the following application form.
For more information email: VRInfo
Last updated: 01/01/2008