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It collects requester details, relationship to the person named, and the reason for the request, along with marriage or divorce party names, dates, places, copy count, and the circuit court where the license was issued or the divorce granted. 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Checks or money orders must be made payable to the State Health Department, and returned checks incur a $50.00 service charge.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What identification documents must be submitted with the application?",{"text":114,"@type":110},"The applicant must submit an enlarged, legible, clear photocopy of their identification. 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Please make check or money order payable to State Health Department. There is a $50.00 service charge for returned checks. IMPORTANT: The person requesting the vital record must submit an enlarged, legible (readable) and clear photocopy of their identification.(See list on reverse side)  \n\n| REQUESTER INFORMATION |  |  |  |  |  |  |  | DAYTIME PHONE NUMBER\u003Cbr> Check this box to receive text notifications. Message & data rates may apply. (For cell phone numbers only) |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| NAME OF REQUESTER (PERSON COMPLETING THE APPLICATION) |  |  |  | EMAIL (Include to receive updates about your application) |  |  |  |  |  |\n| NAME OF BUSINESS, if applicable |  |  |  |  |  |  |  |  |  |\n| ADDRESS |  |  | CITY |  | STATE | ZIP CODE |  |  |  |\n| WHAT IS YOUR RELATIONSHIP TO THE PERSON NAMED ON THE CERTIFICATE?\u003Cbr> SELF  MOTHER  FATHER  PARENT ONE  PARENT TWO  ADULT CHILD  CURRENT SPOUSE  ADULT SISTER  ADULT BROTHER\u003Cbr> LEGAL REPRESENTATIVE (Submit Proof)  OTHER (Specify)  |  |  |  |  |  |  |  |  |  |\n| WHAT IS YOUR REASON FOR REQUESTING THIS CERTIFICATE?   |  |  |  |  |  |  |  |  |  |\n| MARRIAGE INFORMATION\u003Cbr>(Check one)  Marriage Certificate  Single Status Letter (Instructions for Single Status Letter are on the reverse side) |  |  |  |  |  |  |  |  |  |\n| PARTY ONE (Check one)  Husband  Wife Spouse (first) (middle) (last) (suffix) |  |  |  |  |  |  |  |  | (maiden name if any) |\n|  |  |  |  |  |  |  |  |  |  |\n| PARTY TWO (Check one)  Husband  Wife  Spouse (first) (middle) (last) (suffix) |  |  |  |  |  |  |  |  | (maiden name if any) |\n| NUMBER OF COPIES | DATE OF MARRIAGE | PLACE OF MARRIAGE (city or county in Virginia) |  |  |  |  | CIRCUIT COURT WHERE LICENSE WAS ISSUED |  |  |\n| DIVORCE INFORMATION |  |  |  |  |  |  |  |  |  |\n| PARTY ONE (Check one)  Husband  Wife Spouse (first) (middle) (last) (suffix) |  |  |  |  |  |  |  |  | (maiden name if any) |\n|  |  |  |  |  |  |  |  |  |  |\n| PARTY TWO (Check one)  Husband  Wife  Spouse (first) (middle) (last) (suffix) |  |  |  |  |  |  |  |  | (maiden name if any) |\n| NUMBER OF COPIES | DATE OF DIVORCE | PLACE OF DIVORCE (city or county Circuit Court) |  |  |  |  | CIRCUIT COURT WHERE DIVORCE WAS GRANTED |  |  |\n| I understand that making a FALSE application for a vital record is a FELONY under state and federal law. I certify and affirm that all information on this form is true and correct.\u003Cbr>X SIGNATURE OF REQUESTER:  \u003Cbr>UNSIGNED APPLICATIONS WILL NOT BE PROCESSED. |  |  |  |  |  |  |  |  |  |\n\nPlease indicate the address you wish the certificate(s) mailed to in the box below. Please type or print clearly.  \n\n| NAME |\n| --- |\n| ADDRESS |\n| CITY/STATE/ZIP CODE |\n\nSend Completed Application To:  \nOffice of Vital Records  \nP. O. Box 1000  \nRichmond, VA 23218-1000  \nContact Information:  \n(804) 662-6200  \n[www.vdh.virginia.gov/vital-records/](www.vdh.virginia.gov/vital-records/)  \nVS6MD-07/26  \nSubmit one (1) document from the primary list OR two (2) documents from the secondary list. The State Registrar reserves the right (§32.1-271C) to accept or deny any application submitted.  \nThe acceptable documents listed may change without prior notice.  \n\n| ACCEPTABLE PRIMARY IDENTIFICATION LIST |  |  |  |\n| --- | --- | --- | --- |\n| 1. | Photo Driver’s License issued by U.S. state, territory, or jurisdiction (unexpired or expired for not more than one year) | 2. | Learners/Instruction Permit issue by U.S. state, territory or jurisdiction (unexpired or expired for not more than one year) |\n| 3. | Photo Identification Card issued by U.S. state, territory, or jurisdiction (unexpired or expired for not more than one year) includes Global Entry Card | 4. | Curren","cbCais6BzU4cAED3","https://ap.wps.com/l/cbCais6BzU4cAED3","pdf",351146,"English","# Requester Information\n# Marriage Information\n# Divorce Information\n# Mailing Address and Contact\n# Fees, Signature, and Legal Notice\n# Acceptable Identification Documents","[{\"question\":\"What fee and payment method are required to request a certified marriage or divorce record?\",\"answer\":\"The form states that Virginia statutes require a $15.00 fee for each certification of a vital record (or for a file search when no certification is made). Checks or money orders must be made payable to the State Health Department, and returned checks incur a $50.00 service charge.\"},{\"question\":\"What identification documents must be submitted with the application?\",\"answer\":\"The applicant must submit an enlarged, legible, clear photocopy of their identification. The form provides acceptable primary and secondary identification lists, such as unexpired or recently expired U.S. photo IDs, passports, and specified alternative documents.\"},{\"question\":\"What information is needed for marriage or divorce sections?\",\"answer\":\"The applicant must provide party information (including husband/wife/spouse and name components), the number of copies, the date, the place (city or county in Virginia), and the circuit court where the license was issued for marriage or where the divorce was granted for divorce.\"}]","VS6MD Marriage Divorce Certificate Application - 7/2026 | PDF",1789829864]