Town of Niskayuna
Application for copy of Marriage Certificate
Name of Groom __________________________________________________________
Groom’s Date of Birth______/_______/__________
Name of Bride (Maiden Name) ______________________________________________
Bride’s Date of Birth _______/_______/_____________
Date of Marriage _______/_______/________________
Where Marriage Took Place (Town/City/Village) ______________________________
Signature ____________________________________________________________
Address ______________________________________________________________
_____________________________________________________________________
Fee: $10 May be paid by money order, cash or bank check payable
to Town of Niskayuna. We CANNOT ACCEPT PERSONAL CHECKS
If applying by mail, please enclose a stamped, self-addressed envelope and return to:
Helen Kopke, Town Clerk, One Niskayuna Circle, Niskayuna, New York 12309.
(518)386-4510
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