APPLICATION FOR CERTIFIED COPY OF

DAKOTA COUNTY RECORD

 

PLEASE TYPE OR PRINT LEGIBLY

 

Full name of owner of record:
 

Full name of groom

 

 

Identify record:   

 

 

 

 

 

Month, day and year of record:
 

For what purpose is this record to be used?   (Use reverse side if more room is needed)

 

 

 

 

 

 

 
 

 

 

 

 

 

 

 

 

 

 


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Certified copies will only be issued to the person named in the document, their immediate family, legal guardians, or legal representatives & Government Officials.   Legal guardians and legal representatives must provide a copy of the document authorizing guardianship or representation.  Government Officials should show some proof how they are affiliated with government.  Applicant must provide photo identification.  By signing this application, applicant attests that the recipient of this record has legal direct, tangible entitlement.

Text Box: Las copias cerificadas solo seran publicado a la persona denominada en el certicicado, en su familia immediata, en guardianes legales, o representates legal y los oficiales del gobrieno.  Guardianes legales y representantes legales deben proporcionar una copia de la tutela de autorizar de documento o representacion.  Los oficiales del gobierno deben mostrar alguna prueba como son afiliados con el gobierno.  El solicitante debe proprcionar foto identification.  Firmando este application, el solicitante atestigua que el recipente de este registro tiene derecho, directo y palpable Text Box: SIGNATURE:  Please insure Full signature is inside all Lines.            

 

 

 

 

 

 

 

 

 


Please print the Name and address of person below to receive the certified copy and whether they will pick up

The document in person or by mail.    (check one)  Pick up ___  Mail ___

Please provide photo identification.  If receiving by mail please send copy of Driver’s License.

Please print clearly on the lines below.

 

                               NAME: _________________________________________________

 

         STREET ADDRESS: _________________________________________________

 

        CITY, STATE & ZIP: _________________________________________________