City of Derby, Connecticut

One Elizabeth Street - 06418

Marc J. Garofalo, MPA, CCTC

Town / City Clerk [email protected]

Telephone (203) 736-1462 Ext. 0

Fax (203) 736-1479

Instructions to Obtain a Marriage License

**For Persons Who Are Getting Married in the City of Derby**

1. LOCATION: The marriage license must be obtained in the city/town where the marriage

ceremony will take place. Therefore, our marriage license is only valid if the ceremony is

taking place somewhere in Derby.

2. DATE: Marriage Licenses are only valid for 65 days from the date of issue. You can obtain

your license at any time 65 days prior and up to the day of the ceremony. It is recommended

you have a date set prior to obtaining your marriage license. Should your license expire, a

new one will need to be issued.

3. OFFICIATOR: Judges, Justices of the Peace who are currently appointed anywhere in the

State of Connecticut, and any Ordained or Licensed members of the clergy are eligible to

perform marriages in Connecticut (including persons who have been ordained through

online ministries and who are given the authority to officiate marriages through such

ministries). A list of current Justices of the Peace who are located in Derby is available on

our website (https://www.derbyct.gov/certificate-fees). For online ordained ministers, a

copy of their “Credentials of Ministry” must also be submitted with your application.

4. APPLICATION: Both parties must complete the attached “Marriage License Worksheet” as

accurately as possible. The information provided will be permanently recorded on your

marriage certificate and must be an accurate reflection of the facts as you know them.

Please do not leave any boxes blank. If any information is unobtainable or unknown, write

“unknown” or draw a line in the corresponding box. If filling out the form online, please

download and save to your computer first so your information will be saved, then reattach to

an email when submitting.

5. IDENTIFICATION: Both parties must provide a copy or photo of the FRONT AND BACK of

both of your current, valid Driver’s Licenses (any state). If you do not currently have a valid

Driver’s License, a government issued photo ID or passport must be provided.

6. FEES: The fee for a marriage license is $50.00. Payment can be made by Cash at the time of

pick up, Money Order, or Credit Card (personal checks are not accepted). If you would also

like to order a certified copy of your Marriage Certificate (issued after it is returned to our

office following the ceremony), you can prepay for that as well and we will mail you your

certified copy upon receipt. A completed “Application for A Copy of Marriage Certificate”

must also be completed and an additional fee of $20.00 is required. A marriage license and

certified copy can be paid for at the same time for a total of $70.00. Please note that if you are

paying by credit card, an additional $2.00 processing fee will apply.

7. SUBMIT: Once completed, all necessary documentation can be submitted to our office by:

Email: vitals@derbyct.gov

Regular Mail: Marriage License Application

Marc J. Garofalo, Derby Town Clerk

1 Elizabeth Street

Derby, CT 06418

Fax: (203) 736-1479

8. DELIVERY: We will e-mail you a DRAFT copy of your Marriage License for final review. Once

accepted, we will issue your official Marriage License and set up an appointment when both

you and your fiancé must appear in-person with your identification to take an oath and sign

it. You will then give the original to your officiant prior to the ceremony. It is the

responsibility of the Officiant to return the signed original license to us to accept into

permanent record, at which time we will issue any certified copies if requested.

Please feel free to contact our office during regular business hours should you have any

questions or need any further assistance.

Congratulations!

License Fee $50

Certified Copy Fee $20

Number of Copies Requested _________ Paid ________

To be Mailed ________ or Picked up__________

Mail to Address

__________________________________________________

_______________________________________________

STATE OF CONNECTICUT

DEPARTMENT OF PUBLIC HEALTH

CITY OF DERBY - MARRIAGE LICENSE WORKSHEET

DATE OF APPLICATION

SPOUSE ONE SPOUSE TWO

NAME (First) (Middle) (Last)

AGE

(If Minor, Probate Judge

Permission is Required)

SEX

DATE OF BIRTH (Mo., Day, Year)

AGE

(If Minor, Probate Judge

Permission is Required)

SEX

DATE OF BIRTH (Mo., Day, Year)

YRS OF COLLEGE

BIRTHPLACE (State or Foreign Country)

EDUCATION (No. Yrs. Completed)

BIRTHPLACE (State or Foreign Country)

EDUCATION (No. Yrs. Completed)

YRS OF COLLEGE

RESIDENCE (No. and Street)

CITY OR TOWN

COUNTY

STATE

CITY OR TOWN

COUNTY

STATE

ADDRESS

OFFICIATOR INFORMATION

NAME

PHONE NUMBER

SOCIAL SECURITY # (### - ## - ####) SOCIAL SECURITY # (### - ## - ####)

CONTACT PHONE NUMBER

NO. OF THIS

MARRIAGE

NO. OF SAME SEX

CIVIL UNIONS

GRADES COMPLETED

1 2 3 4 5 6 7 8 9 10 11 12

GRADES COMPLETED

1 2 3 4 5 6 7 8 9 10 11 12

FATHER / PARENT FULL NAME (LAST NAME PRIOR TO FIRST MARRIAGE)

LAST RELATIONSHIP ENDED BY:

ANNULMENT

DEATH

IF PREVIOUSLY IN MARRIAGE OR CIVIL UNION,

LAST RELATIONSHIP WAS:

MARRIAGE SAME SEX CIVIL UNION

IF PREVIOUSLY IN MARRIAGE OR CIVIL UNION,

LAST RELATIONSHIP WAS:

MARRIAGE SAME SEX CIVIL UNION

LAST RELATIONSHIP ENDED BY:

DISSOLUTION

ANNULMENT

PREVIOUS CIVIL UNION DID NOT END. MARRYING CIVIL UNION PARTNER. PREVIOUS CIVIL UNION DID NOT END. MARRYING CIVIL UNION PARTNER.

DEATH DISSOLUTION

NO. OF SAME SEX

MARRIAGE

CIVIL UNIONS

NO. OF THIS

DATE OF MARRIAGE

LOCATION OF CEREMONY ___________________________

Office Use Only:

DATE ISSUED____________________________

DATE RETURNED_________________________

COPIES MAILED/PU_______________________

OFFICIAL CAPACITY NAME OF CHURCH

(CLERGY / JUSTICE OF THE PEACE)

OR CITY/TOWN OF APPOINTMENT

SUPERVISION OR CONTROL BY GUARDIAN OR

CONSERVATOR

YES

MOTHER / PARENT FULL NAME (LAST NAME PRIOR TO FIRST MARRIAGE)

FATHER / PARENT BIRTHPLACE

(State or Foreign Country )

SUPERVISION OR CONTROL BY GUARDIAN OR

CONSERVATOR

YES

MOTHER / PARENT BIRTHPLACE

(State or Foreign Country )

FATHER / PARENT FULL NAME (LAST NAME PRIOR TO FIRST MARRIAGE)

MOTHER / PARENT FULL NAME (LAST NAME PRIOR TO FIRST MARRIAGE)

FATHER / PARENT BIRTHPLACE

(State or Foreign Country )

MOTHER / PARENT BIRTHPLACE

(State or Foreign Country )

City of Derby, Connecticut

One Elizabeth Street - 06418

Marc J. Garofalo, MPA, CCTC

Town / City Clerk

Telephone - 203.736.1462 Ext. 0

FAX - 203.736.1479

[email protected]

Credit Card Authorization Form

CARDHOLDER INFORMATION

Name:

Billing

Street

Address:

City:

State:

Postal

Code:

Country:

Address:

Telep

hone:

(

)

I authorize a

one-time

charge

against

credit

card for

the

following

amount:

$_______________

$50.00 Marriage License Issuance

$_______________

$20.00 Certified Copy of Marriage Certificate

$_______________ $1.00 USPS First Class Mail (Postage)

$_______________ $2.00 Credit Card Processing Fee (2.5% over $80.00)

$_______________ TOTAL CHARGE

CREDIT CARD INFORMATION

Credit Card Type: □ MasterCard □ Visa □ American Express □ Discover Card

Number:

Expiration Month: Expiration Year:

Cardholder

Signature

Date

/ /

Security

Code:

□

State of Connecticut

Department of Public Health

410 Capitol Avenue

Hartford, Connecticut 06134-

0308

Sec. 46b-35a. Refusal to provide services or accommodations related to the solemnization or

celebration of a marriage on religious grounds. Notwithstanding any other provision of law, a

religious organization, association or society, or any nonprofit institution or organization operated,

supervised or controlled by or in conjunction with a religious organization, association or society,

shall not be required to provide services, accommodations, advantages, facilities, goods or

privileges to an individual if the request for such services, accommodations, advantages, facilities,

goods or privileges is related to the solemnization of a marriage or celebration of a marriage and

such solemnization or celebration is in violation of their religious beliefs and faith. Any refusal to

provide services, accommodations, advantages, facilities, goods or privileges in accordance with this

section shall not create any civil claim or cause of action, or result in any state action to penalize or

withhold benefits from such religious organization, association or society, or any nonprofit institution

or organization operated, supervised or controlled by or in conjunction with a religious organization,

association or society.

Sec. 46b-35b. Effect of marriage equality law on provision of adoption, foster care or social

services by religious organization. Nothing in this act shall be deemed or construed to affect the

manner in which a religious organization may provide adoption, foster care or social services if such

religious organization does not receive state or federal funds for that specific program or purpose.

Sec. 46b-38qq. Merger of civil union into marriage by action of the parties. (a) On and after

April 23, 2009, and prior to October 1, 2010, two persons who are parties to a civil union entered into

pursuant to sections 46b-38aa to 46b-38oo, inclusive, may apply for and be issued a marriage

license, provided such persons are otherwise eligible to marry under chapter 815e and the parties to

the marriage will be the same as the parties to the civil union.

(b) After the celebration of such marriage and upon the recording of the license certificate or

notarized affidavit with the registrar of vital statistics of the town where the marriage took place

pursuant to section 46b-34, the civil union of such persons shall be merged into the marriage by

operation of law as of the date of the marriage stated in the certificate or affidavit.

Sec. 46b-38rr. Merger of civil union into marriage by default. Exception. (a) Two persons who

are parties to a civil union established pursuant to sections 46b-38aa to 46b-38oo, inclusive, that has

not been dissolved or annulled by the parties or merged into a marriage by operation of law under

section 46b-38qq as of October 1, 2010, shall be deemed to be married under chapter 815e on said

date and such civil union shall be merged into such marriage by operation of law on said date.

(b) Notwithstanding the provisions of subsection (a) of this section, the parties to a civil union with

respect to which a proceeding for dissolution, annulment or legal separation is pending on October

1, 2010, shall not be deemed to be married on said date and such civil union shall not be merged

into such marriage by operation of law but shall continue to be governed by the provisions of the

general statutes applicable to civil unions in effect prior to October 1, 2010.

MARRIAGE LICENSE LAWS

OF CONNECTICUT

Sections 46b-20 to 46b-35b, inclusive,

& Sections 46b-38qq to 46b-38rr

of the Connecticut General Statutes

Section 46b-20. Definitions.

As used in this chapter:

(1) "Registrar" means the registrar of vital statistics;

(2) "Applicant" means applicant for a marriage license;

(3) "License" means marriage license; and

(4) "Marriage" means the legal union of two persons.

Section 46b-20a. Eligibility to Marry.

(a) A person is eligible to marry if such person is:

(1) Not a party to another marriage, or a relationship that provides substantially

the same rights, benefits and responsibilities as a marriage, entered into in

this state or another state or jurisdiction, unless the parties to the marriage will

be the same as the parties to such other relationship;

(2) Except as provided in subsection (b) of this section, at least eighteen years of

age;

(3) Except as provided in section 46b-29, not under the supervision or control of a

conservator; and

(4) Not prohibited from entering into a marriage pursuant to section 46b-21.

(b) A license may be issued to a minor who is at least sixteen years of age but under eighteen

years of age with the approval of the Probate Court as provided in this subsection. A parent or

guardian of a minor may, on behalf of the minor, petition the Probate Court for the district in which

the minor resides seeking approval for the issuance of a license to such minor. The court shall

schedule a hearing on the petition and give notice to the minor, the minor's parents or guardians

and to the other party to the intended marriage. The minor and the petitioning parent or guardian

shall be present at such hearing. The court may, in its discretion, require the other party to the

intended marriage to be present at such hearing. After a hearing on the petition, the court may

approve the issuance of a license to the minor if the court finds that: (1) The petitioning parent or

guardian consents to the marriage; (2) the minor consents to the marriage and such consent is

based upon an understanding of the nature and consequences of marriage; (3) the minor has

sufficient capacity to make such a decision; (4) the minor's decision to marry is made voluntarily

and free from coercion; and (5) the marriage would not be detrimental to the minor.

Section 46b-21. Marriage of persons related by consanguinity or affinity prohibited.

No person may marry such person's parent, grandparent, child, grandchild, sibling, parent's sibling,

sibling's child, stepparent or stepchild. Any marriage within these degrees is void.

Sec. 46b-22. (Formerly Sec. 46-3). Who may join persons in marriage. Penalty for

unauthorized performance. (a) Persons authorized to solemnize marriages in this state include

(1) all judges and retired judges, either elected or appointed, including federal judges and judges of

other states who may legally join persons in marriage in their jurisdictions, (2) family support

magistrates, state referees and justices of the peace who are appointed in Connecticut, and (3) all

VS-12 Rev. 01/01/18

ordained or licensed members of the clergy, belonging to this state or any other state. All marriages

solemnized according to the forms and usages of any religious denomination in this state, including

marriages witnessed by a duly constituted Spiritual Assembly of the Baha'is, are valid. All

marriages attempted to be celebrated by any other person are void.

(b) No public official legally authorized to issue marriage licenses may join persons in marriage

under authority of a license issued by himself, or his assistant or deputy; nor may any such

assistant or deputy join persons in marriage under authority of a license issued by such public

official.

Sec. 46b-22a. Validation of marriages performed by unauthorized justice of the peace. All

marriages celebrated before June 7, 2006, otherwise valid except that the justice of the peace

joining such persons in marriage did not have a valid certificate of qualification, are validated,

provided the justice of the peace who joined such persons in marriage represented himself or herself

to be a duly qualified justice of the peace and such persons reasonably relied upon such

representation.

Section 46b-22b. Refusal to solemnize of participate in ceremony solemnizing a marriage on

religious grounds.

(a) No member of the clergy authorized to join persons in marriage pursuant to section 46b-22 of

the general statutes shall be required to solemnize any marriage in violation of his or her right

to the free exercise of religion guaranteed by the first amendment to the United States

Constitution or section 3 of article first of the Constitution of the state.

(b) No church or qualified church-controlled organization, as defined in 26 USC 3121, shall be

required to participate in a ceremony solemnizing a marriage in violation of the religious beliefs

of that church or qualified church-controlled organization.

Sec. 46b-23. (Formerly Sec. 46-4). Joining persons in marriage knowingly without authority.

Any person who undertakes to join persons in marriage, knowing that he is not authorized to do so,

shall be fined not more than five hundred dollars or imprisoned not more than one year or both.

Sec. 46b-24. (Formerly Sec. 46-5a). License. Period of validity. Penalty for solemnization

without license. Validity of marriage ceremony. (a) Except as provided in section 46b-28a, no

persons may be joined in marriage in this state until both have complied with the provisions of this

section, section 46b-25 and sections 46b-29 to 46b-33, inclusive, and have been issued a license

by the registrar for the town in which the marriage is to be celebrated, which license shall bear the

certification of the registrar that the persons named therein have complied with the provisions of

said sections.

(b) Such license, when certified by the registrar, is sufficient authority for any person authorized to

perform a marriage ceremony in this state to join such persons in marriage, provided the ceremony

is performed within a period of not more than sixty-five days after the date of application.

be fined not more than one hundred dollars.

(d) Except as otherwise provided in this chapter, in order to be valid in this state, a marriage

ceremony shall be conducted by and in the physical presence of a person who is authorized to

solemnize marriages.

Sec. 46b-24a. Validation of marriages occurring in town other than town where license

issued. All marriages celebrated before June 7, 2006, otherwise valid except that the license for

any such marriage was issued in a town other than the town in this state in which such marriage

was celebrated, or where either party to the marriage resided at the time of the marriage license

application, are validated.

Sec. 46b-25. (Formerly Sec. 46-5b). Application for license. No license may be issued by the

registrar until both persons have appeared before the registrar and made application for a license.

The registrar shall issue a license to any two persons eligible to marry under this chapter. The

license shall be completed in its entirety, dated, signed and sworn to by each applicant and shall

state each applicant's name, age, race, birthplace, residence, whether single, widowed or divorced

and whether under the supervision or control of a conservator or guardian. The Social Security

numbers of both persons shall be recorded in the "administrative purposes" section of the license. If

the license is signed and sworn to by the applicants on different dates, the later date shall be

deemed the date of application.

Sec. 46b-28. When marriages in foreign country are valid. All marriages in which one or both

parties are citizens of this state, celebrated in a foreign country, shall be valid, provided: (1) Each

party would have legal capacity to contract such marriage in this state and the marriage is

celebrated in conformity with the law of that country; or (2) the marriage is celebrated, in the

presence of the ambassador or minister to that country from the United States or in the presence of

a consular officer of the United States accredited to such country, at a place within his consular

jurisdiction, by any ordained or licensed clergyman engaged in the work of the ministry in any state

of the United States or in any foreign country.

Section 46b-28a. Recognition of marriages and other relationships entered into in another

state or jurisdiction. A marriage, or a relationship that provides substantially the same rights,

benefits and responsibilities as a marriage, between two persons entered into in another state or

jurisdiction and recognized as valid by such other state or jurisdiction shall be recognized as a valid

marriage in this state, provided such marriage or relationship is not expressly prohibited by statute

in this state.

Section 46b-28b. Recognition by another state or jurisdiction of marriages entered into in

this state. A marriage between two persons entered into in this state and recognized as valid in

this state may be recognized as a marriage, or a relationship that provides substantially the same

rights, benefits and responsibilities as a marriage, in another state or jurisdiction if one or both

persons travel to or reside in such other state or jurisdiction.

Section 46b-28c. Prior divorce in another state or country. Validity of marriage in this state. No

marriage shall be presumed to be invalid or bigamous because a prior divorce of one of the parties

that was entered legally in another state or country does not meet the jurisdictional requirements of

the law of this state.

Section 46b-28d. Recognition of marriage entered into at Mashantucket Pequot reservation

or Mohegan reservation. All marriages celebrated before May 27, 2016, under a tribal marriage

license at the Mashantucket Pequot reservation or Mohegan reservation are recognized as a valid

marriage in this state, provided the marriage is recognized under the laws of the Mashantucket

Pequot Tribal Nation or the Mohegan Tribe of Indians of Connecticut and not otherwise expressly

prohibited by statute in this state.

Sec. 46b-29. (Formerly Sec. 46-5e). Marriage of persons under conservatorship. (a) No

marriage license may be issued to any applicant under the supervision or control of a conservator,

appointed in accordance with sections 45a-644 to 45a-662, inclusive, unless the written consent of

the conservator, signed and acknowledged before a person authorized to take acknowledgments of

conveyances under the provisions of section 47-5a, or authorized to take acknowledgments in any

other state or country, is filed with the registrar.

Sec. 46b-33. (Formerly Sec. 46-5j). Copy of law to applicants. Each registrar shall issue a copy

of sections 46b-24, 46b-25 and 46b-29 to 46b-33, inclusive, to any person making application for a

license.

Sec. 46b-34. (Formerly Sec. 46-7). Marriage certificate. Affidavit in lieu of certificate. (a) Each

person who joins any person in marriage shall certify upon the license certificate the fact, time and

place of the marriage, and return it to the registrar of the town where the marriage took place, before

or during the first week of the month following the marriage. Any person who fails to do so shall be

fined not more than ten dollars.

(b) If any person fails to return the certificate to the registrar, as required under subsection (a) of this

section, the persons joined in marriage may provide the registrar with a notarized affidavit attesting

to the fact that they were joined in marriage and stating the date and place of the marriage. Upon the

recording of such affidavit by the registrar, the marriage of the affiants shall be deemed to be valid

as of the date of the marriage stated in the affidavit.

Sec. 46b-35. Certificates prima facie evidence. The certificates required by sections 46b-24, 46b-

24a, 46b-25 and 46b-29 to 46b-34, inclusive, or an affidavit recorded pursuant to subsection (b) of

section 46b-34, shall be prima facie evidence of the facts stated in them.