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2 Are you applying for your own marriage certificate? Yes/No If not please state your relationship to the person to whom the certificate relates: |
3 DETAILS OF MARRIAGE CERTIFICATE REQUIRED | ||||
SPOUSE | PARTNER | |||
SURNAME DUFFIELD | SURNAME JEVONS | ANY OTHER SURNAME USED BEFORE THIS MARRIAGE
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FORENAME(S) Arthur | FORENAME(S) Hannah | |||
DATE OF MARRIAGE | PLACE OF MARRIAGE | |||
DAY |
MONTH |
YEAR 1920 |
NAME OF BUILDING, CHURCH OR REGISTER OFFICE AND LOCALITY
Tipton, St Matthew |
4 REQUIREMENTS | Send this Application to: |
MARRIAGE CERTIFICATE £11.00 | Superintendent Registrar, Sandwell Register Office, Highfields, High Street, West Bromwich, West Midlands, B70 8RJ, UK |
I requireNUMBER marriage certificate(s) |
5 REMITTANCE ENCLOSED (POSTAL APPLICATIONS ONLY) | ||
UK: applications should enclose an SAE. Postal order or cheque made payable to :
Superintendent Registrar for £ 11.00
Overseas: applications should enclose a self addressed envelope and two IRCs, with payment by Bankers Sterling Draft payable to : Superintendent Registrar |
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The Fee for a certificate issued against this form 'as printed' will not be
refunded. You are strongly recommended to add any qualifying information you may have in order to help the registrar issue the correct certificate. |