Indiana State Department of Health Marriage Record Form
This form is used to record marriage details as required by the Indiana State Department of Health. It gathers personal information from both applicants and must be completed by the officiant. The completed form should be forwarded to the ISDH at the end of each calendar month.
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How do I fill this out?
Filling out this form requires accuracy and attention to detail. You will need to provide personal information for both applicants as well as details about the marriage ceremony. Ensure that the officiant properly signs and completes the necessary sections.

How to fill out the Indiana State Department of Health Marriage Record Form?
1
Enter the personal information of Applicant 1.
2
Enter the personal information of Applicant 2.
3
Fill in the marriage details including date, city, and officiant information.
4
Applicants must sign the form.
5
The officiant must complete and sign their section.
Who needs the Indiana State Department of Health Marriage Record Form?
1
Individuals applying for a marriage license in Indiana need this form to record their marriage details.
2
Officiants need this form to certify that a marriage has been solemnized.
3
County clerks use this form to document marriages within their jurisdiction.
4
The Indiana State Department of Health requires this form for record-keeping purposes.
5
Researchers may use aggregated data from these forms for demographic studies.
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What are the instructions for submitting this form?
To submit this form, provide completed details and submit it to the Indiana State Department of Health at the close of each calendar month. Send the form to Vital Statistics, ISDH, at 2 North Meridian Street, Indianapolis, IN 46204. For any inquiries, you may contact the department via phone or visit their official website for more information.
What are the important dates for this form in 2024 and 2025?
The form is to be used for marriages recorded within the calendar year. Ensure that the form is submitted to the Indiana State Department of Health by the end of each month.

What is the purpose of this form?
The Indiana State Department of Health Marriage Record Form is necessary for recording the official details of a marriage as required by state law. This form captures essential personal information from both applicants, including their social security numbers, places of birth, and previous marital status. Additionally, it includes details about the marriage ceremony itself, such as the date, location, and officiant details. Completion and submission of this form ensure that the marriage is legally recognized by the state and properly documented within the county records. It serves as a crucial record for both personal and legal purposes, making it an essential part of the marriage process. The form must be signed by the officiant and both applicants to validate the marriage. Once completed, the form should be forwarded to the Indiana State Department of Health at the close of each calendar month. This ensures that the state's vital records are kept up-to-date and accurately reflect the marital status of its residents. Properly completing and submitting this form is important for maintaining accurate and legal marriage records.

Tell me about this form and its components and fields line-by-line.

- 1. Name: First, middle, and last names of both applicants.
- 2. Social Security Number: Social security numbers of both applicants.
- 3. Place of Birth: State or foreign country of birth for each applicant.
- 4. Residence: Current street, city, state, and ZIP code or foreign country address of each applicant.
- 5. Sex: Sex of each applicant.
- 6. Race: Race of each applicant, multiple choices allowed.
- 7. Ethnicity: Hispanic or Latino, Not Hispanic or Latino.
- 8. Usual Occupation: Current occupation of each applicant.
- 9. Education: Highest grade completed by each applicant.
- 10. Previous Marital Status: Previous marital status and information about prior marriages.
- 11. Full Name of Parent: Full names of parents for both applicants.
- 12. Birthplace of Parent: State or foreign country of birth for the parents of both applicants.
- 13. Date & Place of Marriage: Date, city or town, and county of the marriage.
- 14. Signature of Applicants: Signatures of both applicants.
- 15. Officiant Information: Name, title, address, and contact information for the officiant.
- 16. Clerk of Court: Signature and seal of the clerk of the court.
What happens if I fail to submit this form?
If the form is not submitted, the marriage may not be legally recognized.
- Legal Status: The marriage may not be legally recognized.
- Vital Records: Incomplete vital records for the state.
- Future Legal Issues: Potential legal issues regarding marital status in the future.
- Documentation Errors: Errors or discrepancies in vital records data.
- Non-compliance: Non-compliance with state laws and regulations.
How do I know when to use this form?

- 1. Marriage License Application: To record the marriage license details.
- 2. Legal Recognition: To ensure the marriage is legally recognized.
- 3. Vital Records: To update the state's vital records with marriage details.
- 4. County Records: To document the marriage within county records.
- 5. Personal Records: To provide an official document of marriage for personal use.
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