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Tippecanoe County Clerk
Marriage Record - Certified/Marriage Dissolution Decree
Complete Name of Party1
Date of Birth (Party1) (Marriage License Request)
(mm-dd-yyyy)
Complete Name of Party2
Date of Birth (Party2) (Marriage License Request)
(mm-dd-yyyy)
Maiden or Last Name at the time of marriage
Record needed:
Both
Divorce/Dissolution Decree
Marriage Record
Approx. Date of Wedding (If needing Marriage Record)
(mm-dd-yyyy)
Approx. Date of Dissolution (If needing Divorce Decree)
(mm-dd-yyyy)
Person Requesting
Submitter Name
Address
City
State
ZIP
Phone Number
Ext.
Fax#
Number of Copies Requested (Marriage Records)
Email Address
Best Time and way to contact you
Comments
Once your record is located, we will contact you with the cost of how you would like to obtain records. Thank you.
Attach Document (PDF, JPG, PNG, GIF, TIFF Only)
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