MARRIAGE OFFICIANT REGISTRATION

THE CITY OF NEW YORK

OFFICE OF THE CITY CLERK

MARRIAGE LICENSE BUREAU

(PRINT CLEARLY IN BLACK INK)

Part 1

Name: Title:

Business Address: Business Telephone No.:

Residential Address: Residential Telephone No.:

Denomination (if applicable):

(Fill out only one of the applicable sections below)

Part 2 (For members of the clergy only)

My denomination publishes a directory of clergy and (Check only one of the following)

[ ] I have attached hereto a copy of the cover page of such directory as well as a copy of the page where my name appears; or

[ ] I have attached a letter from the publishers of the directory confirming my listing in the directory; or

[ ] I have attached proof of my graduation from ______________________ which pertains to the denomination listed in Part 1.

Part 3 (For members of the clergy only)

[ ] My denomination does not publish a directory of clergy and

(a) I have attached hereto either (i) a copy of my ordination certificate (accompanied by an English translation, if necessary); or

(ii) a “license to minister” or a letter of appointment from my religious body;

and

(b) I have attached hereto a letter from my local congregation verifying that I am the pastor or associate pastor of that congregation and

that such congregation consents to my registration (See Sample Letter A on our website);

and

(c) I have attached hereto either (i) a copy of the church’s articles of incorporation or (ii) a statement as to the location of the church, the

reason for its founding, the number of trustees, the approximate size of its congregation and how often it meets (See Sample Letter B on

our website).

Part 4 (For members of the clergy only)

[ ] My denomination does not publish a directory of clergy and does not grant certificates of ordination or licenses to minister and

(a) I have attached hereto a letter from my congregation stating that I am the recognized spiritual leader of that congregation and that such

congregation consents to my registration (See Sample Letter C on our website);

and

(b) I have attached hereto a statement as to the location of the church, the reason for its founding, the number of trustees, the approximate

size of its congregation and how often it meets (See Sample Letter B on our website).

Part 5 (For other marriage officiants only)

[ ] I am a judge and have presented herewith identification that shows me to be a member of the judiciary of the Unified Court System of

the State of New York.

[ ] I am a retired judge and have presented herewith proof that I have been certified pursuant to paragraph (j) of subdivision two of

Section 212 of the Judiciary Law.

[ ] I am a _________________ or a chaplain of the armed forces of the United States and have presented herewith identification that

shows me to be holder of such office or occupation.

I solemnly swear, under penalty of perjury, that the foregoing information is true and correct and is herein stated to induce the City

Clerk to register my name in the directory of marriage officiants pursuant to Section 11-b of the Domestic Relations Law.

X _________________________________________________________ Date:_______________________________

Signature

(must be signed in the presence of clerk or notarized) DO NOT PRINT

Sworn to before me this ____day of __________20____ Notary Stamp Here:

_____________________________________

Notary Public Commission expires:

Please attach a photocopy of your

valid identification. For a list of

acceptable forms of identification

please go to our website:

WWW.CITYCLERK.NYC.GOV

Fee $15 -

payable by money

order made payable to the City

Clerk. Credit card payments are

only accepted in person.