P ALLANTE
CENTER for
ITALIAN
RESEARCH

DOCUMENT SERVICE - ITALY

CHURCH RECORDS


Use this form to request an official certificate from a church-- 1820 or after. (Prior to 1820 request "lineage research")

Normally most churches will send a typed certificate, if the information you request is found.
*Usually, you only need to know the name of the town.

Please sign: I understand that I am paying a nonrefundable fee to "request a search" and
there is no guarantee the document(s) requested will be found. (Occasionally, the document requested may not exist). _____________________

Circle the type of document needed: (Fill out a separate form for each)BAPTSM, MARRIAGE, or DEATH / BURIAL

Print clearly
Full Name of Your Ancestor: _____________________________: ___Male __ Female
Name of Your Ancestor's Spouse: ________________________
Your Ancestor's Parent’s: (use maiden name for mother)
Father: __________________________
Mother: __________________________(surname before marriage)________________
Exact Date of Event: __________________________
Year (if month & day are unknown) ________
If date is unsure, you should first request a search of civil records, unless it is known that there are no such records existing
due to fire or other damage. In this case choose a three year range to be searched (From: ____ To: _____)

Name of Parish (if known):______________________________
Name of Town:________________ Name of Province: ______________

Source of your information: _________________:(eg. Is it from specific documents you’ve found, family stories, or a calculated guess?)

WHERE SHOULD WE SEND THE RESULTS OF THE SEARCH?
(Please print neatly)
Name: ___________________________________
Address: _________________________________
Postal Code: ______________________________
Country: _________________________________
Email: ___________________________________

THANK YOU FOR YOUR ORDER. *Please enclose a self-addressed, stamped envelope for a reply. Allow about 9 weeks.

PAYMENT METHODS: Credit Card (USA only): VISA, Mastercard, American Express, Discover(Print Clearly!)
Account Number: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ Expiration date: (month & year) ___/__ Security Code __ __ __ __
Name on card: __________________________________ Authorizing Signatue: ______________________________________

Personal Check (USA only) payable to "Pallante Center" or use Paypal.com

Outside USA: Int'l Bank check or Postal Money Order.

Mail this form to:

Pallante Center for Italian Research
Documents - Italy
P.O. Box 4664
Queensbury, NY 12804
USA