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The California VS116 form plays a critical role in the process of declaring a marriage. This form is essential for couples who have been married but do not have an official record of their marriage. It requires detailed personal information from both parties, including full names, dates of birth, and places of birth. Additionally, the form captures data regarding any previous marriages, ensuring that all relevant marital history is disclosed. Signatures from both individuals are necessary, along with those of two witnesses, to validate the declaration. The VS116 form also allows couples to request a change of name upon marriage, should they choose to do so. Completing this form accurately is crucial, as it must be submitted within a specific timeframe to be registered officially. The information collected not only establishes a permanent record of the marriage but also serves various legal and administrative purposes, such as applying for benefits or securing identification documents. Adhering to the guidelines laid out in the form ensures that the marriage is recognized legally within the state of California.

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Groom Bride

FIRST PERSON DATA

LICENSE AND CERTIFICATE OF

DECLARATION OF MARRIAGE

 

MUST BE LEGIBLE – MAKE NO ERASURES, WHITEOUTS, OR OTHER ALTERATIONS

 

 

 

STATE FILE NUMBER

USE DARK INK ONLY

 

 

 

LOCAL REGISTRATION NUMBER

 

1A. FIRST NAME

 

 

1B. MIDDLE

 

 

 

 

 

 

 

 

1C. CURRENT LAST

 

 

1D. LAST NAME AT BIRTH (IF DIFFERENT THAN 1C)

 

 

 

 

 

 

 

 

 

2. DATE OF BIRTH (MM/DD/CCYY)

3. STATE/COUNTRY OF BIRTH

4. #PREV. MARRIAGES/SRDP

5A. LAST MARRIAGE/SRDP ENDED BY:

 

5B. DATE ENDED (MM/DD/CCYY)

 

 

 

 

 

DEATH DISSO ANNULMENT TERM SRDP

N/A

 

6. ADDRESS

 

7. CITY

 

8. STATE/COUNTRY

 

9. ZIP CODE

 

 

 

 

 

 

 

 

 

10A. FULL BIRTH NAME OF FATHER/PARENT

 

 

10B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY)

 

 

 

 

 

 

11A. FULL BIRTH NAME OF MOTHER/PARENT

 

 

11B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY)

 

12A. FIRST NAME

 

 

12B. MIDDLE

 

 

 

Groom Bride

SECOND PERSON DATA

AFFIDAVIT

12C. CURRENT LAST

 

 

12D. LAST NAME AT BIRTH (IF DIFFERENT THAN 12C)

 

 

 

 

 

 

 

 

13. DATE OF BIRTH (MM/DD/CCYY)

14. STATE/COUNTRY OF BIRTH

15. # PREV. MARRIAGES/SRDP

16A. LAST MARRIAGE/SRDP ENDED BY:

 

16B. DATE ENDED (MM/DD/CCYY)

 

 

 

 

DEATH

DISSO ANNULMENT TERM SRDP

N/A

 

 

 

 

 

 

 

 

 

17. ADDRESS

 

18. CITY

 

19. STATE/COUNTRY

 

20. ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

21A. FULL BIRTH NAME OF FATHER/PARENT

 

 

 

21B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY)

 

 

 

 

 

 

 

 

22A. FULL BIRTH NAME OF MOTHER/PARENT

 

 

 

22B. STATE OF BIRTH (IF OUTSIDE U.S. ENTER COUNTRY)

WE, THE UNDERSIGNED, DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE AND BELIEF. WE FURTHER DECLARE THAT WE ARE PRESENTLY MARRIED TO EACH OTHER, THAT A CALIFORNIA MARRIAGE LICENSE WAS OBTAINED PRIOR TO THE CEREMONY, AND THAT THE CEREMONY OCCURRED IN CALIFORNIA. WE ACKNOWLEDGE RECEIPT OF THE INFORMATION REQUIRED BY FAMILY CODE SECTION 358 AND HEREBY APPLY FOR A LICENSE AND CERTIFICATE OF DECLARATION OF MARRIAGE.

23. SIGNATURE OF PERSON LISTED IN FIELDS 1A-1D

24. SIGNATURE OF PERSON LISTED IN FIELDS 12A-12D

 

LICENSE TO MARRY

CERTIFICATION

OF MARRIAGE

TO THE MARRIAGE

REQUIRED)

WITNESSES

(TWO

I, THE UNDERSIGNED, DO HEREBY CERTIFY THAT THE ABOVE-NAMED PARTIES HAVE PERSONALLY APPEARED BEFORE ME AND PROVED TO ME ON THE BASIS OF SATISFACTORY EVIDENCE TO BE THE PERSONS CLAIMED, HAVE DECLARED THAT THEY MEET ALL THE REQUIREMENTS OF THE LAW, AND HAVE PAID THE FEES PRESCRIBED BY LAW. THESE REQUIREMENTS HAVING BEEN MET, I HEREBY ISSUE THE LICENSE AND CERTIFICATE OF DECLARATION OF MARRIAGE.

25A. ISSUE DATE (MM/DD/CCYY)

25B. EXPIRES AFTER (MM/DD/CCYY)

25C. NAME OF COUNTY CLERK

25D. SIGNATURE OF CLERK OR DEPUTY CLERK

 

 

 

BY

25E. MARRIAGE LICENSE NUMBER

25F. COUNTY OF ISSUE

25G. RETURN COMPLETED MARRIAGE LICENSE TO (INCLUDE ADDRESS):

WE, THE ABOVE-NAMED PARTIES, DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA, THAT WE WERE JOINED IN MARRIAGE IN ACCORDANCE WITH THE LAWS OF THE STATE OF CALIFORNIA AS INDICATED BELOW.

26A. DATE OF MARRIAGE (MM/DD/CCYY)

26B. CITY/TOWN OF MARRIAGE

26C. COUNTY OF MARRIAGE

 

 

 

 

27. SIGNATURE OF PERSON LISTED IN FIELDS 1A-1D

 

 

28. SIGNATURE OF PERSON LISTED IN FIELDS 12A-12D

 

 

 

 

WE, THE UNDERSIGNED, DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA, THAT WE WERE PHYSICALLY PRESENT AT THE MARRIAGE CEREMONY OF THE ABOVE-NAMED PARTIES, THAT WE WITNESSED THE ABOVE-NAMED PERSONS COMPLETE THE MARRIAGE CEREMONY, THAT THE CEREMONY OCCURRED IN CALIFORNIA, AND THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE AND BELIEF.

29A. SIGNATURE OF WITNESS

29B. NAME OF PERSON WITNESSING MARRIAGE (TYPE OR PRINT CLEARLY)

 

 

 

 

29C. ADDRESS, CITY, STATE/COUNTRY, AND ZIP CODE

 

 

 

 

 

30A. SIGNATURE OF WITNESS

30B. NAME OF PERSON WITNESSING MARRIAGE (TYPE OR PRINT CLEARLY)

 

 

 

 

30C. ADDRESS, CITY, STATE/COUNTRY, AND ZIP CODE

 

 

NEW NAMES (IF ANY)

NEW MIDDLE AND LAST NAME OF PERSON LISTED IN 1A-1D (IF ANY) FOR USE UPON SOLEMNIZATION OF THE MARRIAGE (SEE REVERSE FOR INFORMATION)

31A. FIRST – MUST BE SAME AS 1A

31B. MIDDLE

31C. LAST

 

NEW MIDDLE AND LAST NAME OF PERSON LISTED IN 12A-12D (IF ANY) FOR USE UPON SOLEMNIZATION OF THE MARRIAGE (SEE REVERSE FOR INFORMATION)

32A. FIRST – MUST BE SAME AS 12A

32B. MIDDLE

32C. LAST

LOCAL

33A. NAME OF LOCAL REGISTRAR

33B. SIGNATURE OF CLERK OR DEPUTY CLERK

33C. DATE ACCEPTED FOR REGISTRATION

 

 

 

REGISTRAR

 

BY

 

 

 

 

STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH, OFFICE OF VITAL RECORDS

VS-116 (01/01/2010)

INSTRUCTIONS AND INFORMATION

Refunds CANNOT be given after a marriage license is issued.

You will not be notified that your license has been registered. You do not automatically receive a certified copy. You must request and pay for a certified copy from the local registrar of marriages (County Recorder) in the county where the license was issued.

SRDP = State Registered Domestic Partnership as registered with the Secretary of State. Pursuant to Family Code, Section 298.5(c), no person who has filed a Declaration of Domestic Partnership may enter a marriage with someone other than their registered domestic partner unless the most recent domestic partnership has been terminated or a final judgment of dissolution or nullity has been entered, or the domestic partnership terminated due to death of one of the domestic partners.

“New Name(s)”—Law applying to middle and last names (items 31B, 31C, 32B, and 32C) OPTIONAL: Pursuant to Family Code Section 306.5, at the time of application for a marriage license, one or both parties to the marriage may elect to change the middle or last names, or both, by which that party wishes to be known after solemnization of the marriage by entering that information on the marriage license application. Parties may adopt any of the following middle names: the current last name of either spouse; the last name of either spouse given at birth; a hyphenated combination of the current middle name and the current last name of the person or spouse; a hyphenated combination of the current middle name and the last name given at birth of the person or spouse. Parties may adopt any of the following last names: the current last name of the other spouse; the last name of either spouse given at birth; a name combining into a single last name all or a segment of the current last name or last name of either spouse given at birth; a hyphenated combination of last names. NOTE: The first name of the parties may not be changed on the marriage license. An amendment to the new name fields may only be issued to correct clerical errors, and that amendment must be signed by one of the parties to the marriage and the county clerk or his or her deputy.

PURCHASE OF A LICENSE

All persons must purchase a License and Certificate of Declaration of Marriage from the County Clerk in the parties’ county of residence in order to declare a California marriage which has been solemnized, but for which no official record exists (Family Code Section 425).

To Persons Declaring Their Marriage

The License and Certificate of Declaration of Marriage expires 90 days after date of issue in Item 25A and cannot be used after the “Expiration Date” shown in Item 25B. A declared marriage is a public record. If you are declaring a marriage that originally used a Confidential Marriage License, using this License and Certificate of Declaration of Marriage would then make it a public record.

1.Complete the marriage license using DARK INK ONLY.

2.Enter date and place of marriage in Items 26A, 26B, and 26C.

3.Sign your names in Items 27 and 28.

4.Have two witnesses to the marriage sign Items 29A and 30A and complete Items 29B, 29C, 30B and 30C.

The completed LICENSE AND CERTIFICATE OF DECLARATION OF MARRIAGE must be returned within 10 days of completion by either of the parties declaring the marriage to be registered by the local registrar of marriages (County Recorder) of the county where the license was issued at the address in box 25G. It can be mailed or delivered in person.

PRIVACY NOTIFICATION

Civil Code Section 1798 et seq. requires each state agency to provide this notice to individuals completing this form. The information is being requested by: State of California, Department of Public Health, Office of Vital Records, MS 5103, P.O. Box 997410, Sacramento, CA 95899- 7410, Telephone (916) 445-2684.

The information requested on this certificate is authorized and required by Division 102 of the Health and Safety Code, and related provisions within the Civil Code, Code of Civil Procedure, Family Code, and Government Code.

The completion of all items requested on this form is mandatory. Health and Safety Code Section 103775 provides that, “Every person, except a parent informant for a certificate of live birth, who is responsible for supplying information who refuses or fails to furnish correctly any information in his or her possession which is required by this division, or furnishes false information affecting any certificate or record required by this division, is guilty of a misdemeanor.”

The principal purpose for this record is:

1.To establish a permanent record that is legally recognized as prima facie evidence of the facts stated therein for each marriage occurring in the State of California.

2.To provide individuals with certified copies from the records to serve their personal needs, such as securing passports and applying for social security or death benefits.

3.To provide information to health authorities and other qualified persons with a valid educational or scientific interest, for demographic and epidemiological studies for health and social purposes.

4.This information is also provided to the National Center for Health Statistics for compiling national statistical reports.

This record shall be open for examination during regularly scheduled office hours, except when access is specifically prohibited by statute or regulations.

For Official Use Only

STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH, OFFICE OF VITAL RECORDS

VS-116 (01/01/2010)
➤ PDF File

Form Specifications

Fact Name Details
Form Purpose The California VS116 form is used to declare a marriage that has been solemnized in California.
Governing Law This form is governed by California Family Code, specifically Sections 425 and 306.5.
Legibility Requirement All information must be legible, and alterations such as erasures or whiteouts are not allowed.
Signature Requirement Both parties must sign the form to validate the declaration of marriage.
Witness Requirement Two witnesses must sign the form, confirming their presence at the marriage ceremony.
Expiration The license and certificate expire 90 days after the issue date.
New Name Options Parties may choose to adopt new middle or last names upon marriage, as per Family Code Section 306.5.
Public Record A declared marriage becomes a public record, especially if a Confidential Marriage License was previously used.
Privacy Notification Information collected is protected under Civil Code Section 1798, ensuring privacy during the process.

California Vs116: Usage Guidelines

Filling out the California VS116 form is an essential step in declaring a marriage that has been solemnized. After completing this form, it must be returned to the local registrar of marriages for registration. The following steps will guide you through the process of filling out the form accurately.

  1. Use DARK INK ONLY to fill out the form, ensuring all information is legible.
  2. In the first section, labeled "Groom," provide your first name, middle name, current last name, and last name at birth if it differs from your current last name.
  3. Enter your date of birth in the format MM/DD/CCYY.
  4. Indicate your state or country of birth.
  5. State the number of previous marriages or registered domestic partnerships (SRDP).
  6. For the last marriage or SRDP, specify how it ended and the date it ended.
  7. Fill in your current address, city, state or country, and zip code.
  8. Provide the full birth names of your parents, including their states of birth.
  9. Repeat steps 2 through 8 for the "Bride" section of the form.
  10. Both parties must sign in the designated signature fields to declare that the information provided is true and correct.
  11. Fill out the marriage details, including the date and location of the marriage.
  12. Have two witnesses sign the form, providing their names and addresses as required.
  13. If applicable, indicate any new names that will be adopted after the marriage.
  14. Complete the local registrar section, including the name and signature of the clerk or deputy clerk.
  15. Return the completed form to the local registrar of marriages within 10 days after the marriage ceremony, either by mail or in person.

Your Questions, Answered

What is the California VS116 form used for?

The California VS116 form is a License and Certificate of Declaration of Marriage. It serves as a legal document that allows couples to declare their marriage in California, particularly when there is no official record of the marriage. This form is essential for couples who have had a marriage ceremony but did not obtain a marriage license beforehand or those who wish to formalize their union after a confidential marriage. Completing this form ensures that the marriage is recognized by the state and can be used for various legal purposes, such as applying for benefits or securing a passport.

What information do I need to provide on the VS116 form?

When filling out the VS116 form, you will need to provide detailed personal information for both individuals. This includes full names, dates of birth, birthplaces, and addresses. You will also need to disclose any previous marriages and how they ended, such as through death, dissolution, or annulment. Additionally, both parties must declare their parents' full birth names and their states of birth. It’s crucial to ensure that all information is legible and accurate, as any alterations like erasures or whiteouts are not permitted.

How do I submit the VS116 form after completing it?

Once you have completed the VS116 form, it must be returned to the local registrar of marriages (County Recorder) in the county where the marriage license was issued. This can be done either by mailing the form or delivering it in person. It is important to submit the completed form within 10 days of the marriage ceremony to ensure it is registered properly. Failure to do so may result in complications with the legal recognition of your marriage.

Can I change my name using the VS116 form?

Yes, the VS116 form allows for optional name changes upon marriage. Both parties may choose to adopt new middle or last names by filling out the relevant sections on the form. You can select a name based on various options, such as taking your spouse's last name or creating a hyphenated combination. However, it’s important to note that the first names cannot be changed on this form. Any amendments to the name fields later on must be made to correct clerical errors and require the signatures of both parties involved.

Common mistakes

  1. Illegible Writing: It's crucial to ensure that all information is legible. If the handwriting is unclear, it may lead to delays or issues with processing.

  2. Using Incorrect Ink: Always use dark ink only. Light ink or pencil can cause the form to be rejected.

  3. Altering the Form: Do not make any erasures, whiteouts, or other alterations. If a mistake is made, it's best to start over with a new form.

  4. Missing Signatures: Ensure that all required signatures are present. Missing a signature can prevent the form from being accepted.

Documents used along the form

The California VS116 form is essential for couples looking to declare their marriage officially. However, several other forms and documents are often used in conjunction with the VS116 to ensure that the marriage process is smooth and compliant with state regulations. Below is a list of these documents, each with a brief description to help you understand their purpose.

  • Marriage License Application: This document must be completed and submitted to the county clerk before obtaining a marriage license. It collects personal information about both parties, including names, addresses, and birth dates.
  • Marriage License: This is the official document issued by the county clerk that allows a couple to marry. It must be signed by both parties and filed with the appropriate office after the ceremony.
  • Certificate of Marriage: After the marriage ceremony, this document serves as proof of the marriage. It includes details such as the date and location of the marriage, as well as the names of the couple and witnesses.
  • Witness Affidavit: This form is signed by individuals who witnessed the marriage ceremony. It verifies that the witnesses were present and can attest to the legitimacy of the marriage.
  • Change of Name Form: If either spouse wishes to change their name after marriage, this form may be needed. It outlines the new name the individual wishes to adopt and must be filed with the appropriate authorities.
  • Domestic Partnership Registration: For couples in a domestic partnership, this document registers their partnership with the state. It is necessary for legal recognition and may impact marriage eligibility.
  • Affidavit of Eligibility to Marry: This document declares that both parties are legally eligible to marry, confirming that they are not currently married to someone else and meet other legal requirements.
  • Prenuptial Agreement: While not mandatory, this legal document outlines how assets and responsibilities will be divided in the event of divorce or separation. It is particularly useful for couples with significant assets or children from previous relationships.
  • Certified Copy Request Form: After the marriage is recorded, couples may need to request certified copies of their marriage certificate for legal purposes, such as changing names or applying for benefits.

Understanding these documents can help ensure that your marriage process is completed correctly and efficiently. Each form plays a crucial role in establishing legal recognition of your union and can prevent potential issues in the future. It's always a good idea to check with local authorities or legal professionals if you have questions about any specific requirements.

Similar forms

  • Marriage License Application: Similar to the California Vs116 form, this document is required to obtain a marriage license. It collects essential information about both parties, including names, dates of birth, and previous marriages.
  • Certificate of Marriage: This document serves as an official record of the marriage. Like the Vs116 form, it includes details such as the names of the couple, date, and location of the marriage ceremony.
  • Affidavit of Marriage: This affidavit is a sworn statement that confirms the marriage took place. It parallels the Vs116 form in that both require signatures from the parties involved and witnesses to validate the marriage.
  • Domestic Partnership Registration Form: This form is used for registering a domestic partnership. Similar to the Vs116, it gathers personal information about the partners and their previous relationships.
  • Application for a Marriage Certificate: This application is submitted to request a certified copy of the marriage certificate. It shares the same purpose of documenting the marriage as the Vs116 form.
  • Marriage Dissolution Petition: This document initiates the process of ending a marriage. Like the Vs116, it requires personal information about the parties involved and their marriage history.
  • Name Change Petition: This petition allows individuals to change their names legally. It is similar to the Vs116 in that it includes personal information and may involve the names of family members.
  • Witness Statement for Marriage: This document is used to verify that the witnesses were present at the marriage ceremony. It parallels the Vs116 form by requiring the witnesses' signatures to affirm the event's legitimacy.
  • Marriage Certificate Application for Confidential Marriages: This application is for obtaining a confidential marriage certificate. Like the Vs116, it includes personal details and requires submission to the appropriate county office.

Dos and Don'ts

When filling out the California VS116 form, it is essential to approach the task with care and attention to detail. Below is a list of important do's and don'ts to consider during this process.

  • Do use dark ink only when completing the form.
  • Do ensure all information is legible and accurate.
  • Do enter the date and place of marriage in the specified fields.
  • Do have two witnesses sign the form as required.
  • Do return the completed form within 10 days of the marriage ceremony.
  • Don't make any erasures, whiteouts, or alterations on the form.
  • Don't forget to sign the form in the designated areas.
  • Don't submit the form without ensuring all fields are completed.
  • Don't ignore the expiration date of the marriage license; it is valid for only 90 days.

Misconceptions

  • Misconception 1: The VS116 form is optional for marriage in California.

    • This form is mandatory for couples who wish to declare their marriage. It must be completed and submitted to the local registrar.

  • Misconception 2: You can fill out the form in any color ink.

    • The form must be completed using dark ink only. This ensures that the information is legible and can be processed correctly.

  • Misconception 3: Previous marriages do not need to be disclosed.

    • All previous marriages must be reported on the form. This includes details on how and when they ended.

  • Misconception 4: The form can be altered if mistakes are made.

    • No erasures, whiteouts, or other alterations are allowed. If a mistake occurs, a new form should be filled out.

  • Misconception 5: You automatically receive a certified copy of your marriage certificate.

    • Couples must request and pay for a certified copy from the local registrar after the marriage license is issued.

  • Misconception 6: You can change your first name on the form.

    • The first names of the parties cannot be changed on the marriage license. Only middle and last names may be modified.

  • Misconception 7: The VS116 form is only for heterosexual couples.

    • The form is applicable to all couples, including same-sex partners, as long as they meet the legal requirements for marriage in California.

  • Misconception 8: There is no deadline for submitting the completed form.

    • The completed form must be returned within 10 days of the marriage ceremony to be registered properly.

  • Misconception 9: You can submit the form to any county in California.

    • The form must be submitted to the county where the marriage license was issued. This ensures proper registration.

  • Misconception 10: Witness signatures are not necessary.

    • Two witnesses must sign the form to validate the marriage ceremony. Their signatures are crucial for the legality of the document.

Key takeaways

  • Legibility is Crucial: When filling out the California VS116 form, it is essential to ensure that all information is legible. Use dark ink only and avoid any erasures or whiteouts. This helps prevent confusion and ensures that your application is processed smoothly.

  • Provide Accurate Personal Information: The form requires detailed personal information for both parties, including full names, birth dates, and addresses. Double-check this information to avoid delays or issues with your marriage license.

  • Witness Signatures Required: After the marriage ceremony, two witnesses must sign the form. Their signatures, along with their printed names and addresses, are necessary to validate the marriage declaration.

  • Return the Form Promptly: The completed VS116 form must be returned to the local registrar of marriages within 10 days of the marriage ceremony. This can be done by mail or in person. Failing to submit it on time may result in complications with the official registration of your marriage.