P ALLANTE
CENTER for
ITALIAN
RESEARCH

DOCUMENT SERVICE - ITALY

Marriage Record


Use this form to request a certificate (genelogical extract) of an Italian marriage record, which
will be forwarded from Italy. Use this form only when you know the names, date and place.

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). _____________________

Place of Marriage (town):____________________ Province: ______________
If you do not know the name of the town you must use Form B.

Name of Groom: _____________________________
Groom's father:_____________________________
Groom's mother:_____________________________(Maiden surname of mother)__________________

Name of Bride: _____________________________
Bride's father:_____________________________
Bride's mother:______________________________(Maiden surname of mother)__________________

Exact Date of Marriage: Day___ Month___ Year_____
Year of Marriage (if month & day unknown)_________
If you are unsure of the year choose a three-year range to be searched. (From:_____ To:_____)

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

After 8 weeks, if the search is reported "negative" or there has been no response from the Italian archives office
(which usually means "not found"), submit a new request with a new range of dates, name variation, or town.

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. Allow 6 to 8 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 residents): payable to "Pallante Center" or use Paypal.com .

Outside USA: Int'l postal money order (at your local post office) or Int'l bank draft (your local bank).

Mail this form to:

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