MIKE BRYANTON                               
INGHAM COUNTY CLERK
BOX  179 * MASON, MI  48854
(517) 676-7201 *  FAX (517) 676-7254
Please print and complete the form below and mail or fax it to our office. If you are ordering a certificate by mail, a check or money order made payable to the Ingham County Clerk is acceptable. (Effective December 1, 2004 we cannot accept out-of-State checks). If you are ordering a certificate by fax a Visa or MasterCard must be used. NOTE: If your request is urgent, we will process the request the day it is received (if received before 3:00 p.m. est) and return it to you via USPS Express mail. The charge for this service is $19.00 and will be charged to your credit card.

There is a $17.00 fee for the first certified copy and an $8.00 fee for
each additional copy of the the same record. To expedite, add $19.00

Marriage Certificate

________________________________
Husband's Name (First, Middle, Last)
________________________________
Wife's Name (First, Middle, Last)
 
Date of Marriage: ___________________   Place of Application: ___________________
 
Daytime Telephone (include area code) Mail Certificate to (Name):
Address: No. of Copies:              To expedite, add $19.00
City: State: Zip Credit Card Number:
Applicant Signature:

Visa?  
r

MasterCard?  
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 Exp. Date: