Delta County Marriage and Civil License Application

Civil Union Application

Please fill out the following information as accurately as possible. The Clerks can correct any information before you sign your license.

Please fill in Party 1's information.

Your name must be exactly as it appears on the identification to be presented at time of issuance.

First Name

Middle Name

Last Name

Last Name at Birth If Different

Suffix

Social Security Number

Gender

Street Address

City

State

Zip

Birth Date

Birthplace City and State

Prev Spouse/Partner Name

If divorced or widowed, City & State

If divorced, Date

If divorced, Type of Court

Parent/Guardian Name

Parent/Guardian City and State

Parent/Guardian Name

Parent/Guardian City and State

Please fill in Party 2's information.

Your name must be exactly as it appears on the identification to be presented at time of issuance.

First Name

Middle Name

Last Name

Last Name At Birth If Different

Suffix

Social Security Number

Gender

Street Address

City

State

Zip

Birth Date

Birthplace City and State

Prev Spouse/Partner Name

If divorced or widowed, City & State

If divorced, Date

If divorced, Type of Court

Parent/Guardian Name

Parent/Guardian City and State

Parent/Guardian Name

Parent/Guardian City and State

Please fill in the information.

Are the Applicants Related by Blood?

If related, how?

Review & Submit
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