New York Domestic Relations Code § 14-A

Town and city clerks to issue certificates of marriage registration; form
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§ 14-a. Town and city clerks to issue certificates of marriage\nregistration; form.  1. Upon receipt of the return of the marriage\nlicense, properly endorsed and completed by the person who shall have\nsolemnized a marriage as provided in this article, the town and city\nclerks of each and every town or city in the state shall, after\nabstracting, recording and indexing the statement of performance of\nsolemnization, issue to the couple within fifteen days after such\nreceipt or return of the completed marriage license a certificate of\nmarriage, which certificate shall be substantially in the following form\nand contain the following facts:\n  Record No............of Year........\n                           THIS IS TO CERTIFY\nthat ................................................................. ,\n          first name, premarriage middle and surname,\n          new middle and/or surname (if applicable)\nresiding at .......................................................... ,\nwho was born on ........................., at ........................ ,\n                       date\nand .................................................................. ,\n        first name, premarriage middle and\n        surname, new middle and/or\n        surname (if applicable)\nresiding at .......................................................... ,\nwho was born ........................, at ............................ ,\n                        date\nwere married on.......................at ............................. ,\n                        date\nas shown by the duly registered license and certificate of\nmarriage of said persons on file in this office.\n(SEAL)                            ......................................\n                                               Town or City Clerk\nDated at.................., N. Y.\n.................................\nNo  other  facts  contained  in  the affidavits, statements, consents or\nlicenses shall be  certified  by  such  town  and  city  clerks,  unless\nexpressly  requested  in  writing  by  the  man  or  woman named in such\naffidavit, license, statement or record.\n  2. a. Such town and city clerks shall be entitled to a fee for such\ncertificate, payable at the time of issuance of the marriage license, in\na sum not exceeding ten dollars, to be fixed in the case of town clerks\nby the town board, and in the case of city clerks by the common council\nor governing body of such cities. The town and city clerks shall, upon\nrequest of any applicant whose name appears thereon, issue a similar\ncertificate of marriage, as set forth above, and similarly expanded with\nadditional facts upon the express additional request, for all marriages\nheretofore indexed and recorded in the office of the town or city\nclerks. For such certificate of marriage, the town and city clerks shall\nbe entitled to a fee not exceeding ten dollars, to be fixed in the case\nof town clerks by the town board, and in the case of city clerks by the\ncommon council or governing body of such city.\n  b. In addition to the foregoing, upon request of any applicant whose\nname appears thereon for a certificate of marriage, the town or city\nclerk may issue a photograph, micro-photograph or photocopy of the\nmarriage record on file in the office of such clerk. Such photograph,\nmicro-photograph or photocopy, when certified by the town or city clerk,\nshall be deemed an original record for all purposes, including\nintroduction in evidence in all courts or administrative agencies. For\nsuch certificate of marriage and the certification thereof, the town or\ncity clerk shall be entitled to a fee not exceeding ten dollars, to be\nfixed in the case of town clerks by the town board, and in the case of\ncity clerks by the common council or governing body of such city.\n  3. a. No fee shall be charged for any certificate when required by the\nUnited States department of veterans affairs or by the department of\nveterans' serv

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