Application for License and Certificate of Marriage - California
STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH, OFFICE OF VITAL RECORDS VS-117Be (01/2010)
APPLICATION FOR LICENSE AND CERTIFICATE OF MARRIAGE
PLEASE READ BEFORE COMPLETING APPLICATION
When you sign the marriage application form, you are stating under penalty of perjury that the information you have provided is true and
correct, that you are currently an unmarried couple, and that there is no legal objection to the marriage.
If you are using a regular public marriage license, you may be married anywhere in California. If you are using a confidential marriage license,
you must be married in the same county that issues the license. Check the license to see what the requirements are for witnesses and
solemnization.
Marriage licenses are valid for 90 days from the date of issuance. You must be married on or after the issuance date, and on or before the
expiration date of the license. Licenses not used within this timeframe are void.
The appropriate fee may be paid in cash or by check, payable to the county clerk.
No refunds are given for marriage licenses purchased in error.
Please check the type of marriage license you would like to apply for:
License and Certificate of Marriage (VS 117) — This is the standard type of marriage license. This type of marriage license
requires the signature of at least one witness and one person solemnizing the marriage.
License and Certificate of Marriage for Denominations Not Having Clergy (VS 115) — This type of license is used for the
recording of marriages for members of religious societies or denominations that do not have clergy for the purpose of solemnizing a
marriage.
License and Certificate of Declaration of Marriage (VS 116) — This type of license is used for the recording of a marriage that
was licensed and occurred over one year ago; however, no official record exists.
Confidential License and Certificate of Marriage (VS 123) — Confidential marriage licenses may only be issued to unmarried
parties who are at least 18 years old and have been living together as spouses. Since the confidential marriage license requires the
signature of a marriage officiant, they are not available to members of religious denominations not having clergy. Certified copies of
the marriage license and certificate may only be issued to the couple. Confidential marriage licenses may not be available in all
counties. The signatures of the parties in fields 23 and 24 affirm that they meet the requirements to receive a confidential marriage
license.
INFORMATION REGARDING THE NAME EQUALITY ACT OF 2007
The Name Equality Act of 2007 (AB 102, Chapter 567, Statutes of 2007, amended by AB 1143, Chapter 412, Statutes of 2009) allows one or
both applicants to a California marriage to elect to change the middle and/or last names by which each party wishes to be known after they are
married by entering the new name in fields 29A thru 30C, as applicable, on the marriage license application. This must be done at the time
the applicants are applying for the marriage license.
Each party to the marriage may adopt any of the following last names (Family Code Section 306.5(b)(2)):
Current last name of the other spouse
Last name of either spouse given at birth
A name combining into a single last name all or a segment of the current last name or the last name of either spouse given at birth
A hyphenated combination of last names
Each part to the marriage may adopt any of the following middle names (Family Code Section 306.5 (b)(3):
Current last name of either spouse
The last name of either spouse given at birth
A hyphenated combination of the current middle name and the current last name of the person or spouse
NOTE: Parties to the marriage may not change their first name on the marriage license. Parties to the marriage may not add or amend this
information after the marriage license is issued unless it is a clerical error and the amendment is signed by the county clerk and one of the
parties to the marriage.
Parties to the marriage are not required to change their name, nor, are they required to have the same name.
If one or both parties do not wish to identify a new name on the marriage license, the fields on the marriage license will be
completed using two single dashes. You may not change the information on the marriage license after it has been issued by the
County Clerk.
The marriage certificate is used by multiple local, state, federal and private agencies, each of which have different requirements regarding
what documents are acceptable to change your name on their records following marriage. It is recommended that you contact these agencies
to verify their requirements prior to applying for your marriage license.
County Clerk staff cannot provide you information on how to complete the marriage license application as it relates to the entry of a new name
or retention of your former name on the marriage license application. For your protection, if you have any questions regarding whether you
should or should not list your new name on the marriage license application, and/or how the Name Equality Act of 2007 may affect you, please
consult with a private attorney prior to applying for your marriage license.
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