Application for Florida Dissolution of Marriage Certificate (Divorce or

DH 260, 01/2022, Florida Administrative Code Rule 64V-1.0131 (Obsoletes Previous Editions)

Florida Department of Health

Bureau of Vital Statistics

www.floridahealth.gov/certificates

APPLICATION FOR FLORIDA DISSOLUTION OF MARRIAGE CERTIFICATE

(DIVORCE OR ANNULMENT)

Applicant Information

Any person who willfully and knowingly provides any false information on a certificate, record or report required by Chapter 382, Florida

Statutes, or on an application or affidavit, or who obtains confidential information from any vital record under false or fraudulent

purposes, commits a felony of the third degree, punishable as provided in Chapter 775, Florida Statutes.

Applicant’s Name: _____________________________________________________________________________________

(Person requesting the record)

Mailing Address: ______________________________________________________________________ Apt.#: __________

City: _______________________________________________ State: ___________ ZIP Code: _______________________

Phone (with area code): _____________________________ email: ________________________________________________

Relationship to Person on Record: ____________________________ Signature: __________________________________

VitalChek.com is the ONLY online vendor approved by the Florida Department of Health, Bureau of Vital Statistics to

assist customers in completing the application process. Be cautious when sharing personal information online with

unknown entities and maintain appropriate security on computers and electronic devices.

Information from Final Judgement

Name of Spouse as Shown on Record: ______________________________________________________________________

Date of Dissolution (If unknown, range of years): ________________________________________________________________

County Where Granted: ___________________________ Case # (if known):_______________________________________

Ordering Information

Normal processing time for computer certificates (1970 to present) is 3-5 business days. Records prior to 1970 will be issued

as a photocopy certificates and will require additional processing time.

Fee Quantity

First Certificate: $5.00

$5.00

Additional Certificates: $4.00 each

Additional Years to be Search: $2.00 per year.

(Required when exact year is unknown. Maximum fee is $50.00).

Rush Order (Optional): Rush orders are given priority processing and requires an additional

$10 fee. Mark the outside of your envelope “RUSH”. Expedite shipping is NOT included.

Shipping & Handling Fee per application (Standard U.S. Postal Delivery)

Dissolution of Marriage Reports originate from the Clerk of Circuit Court and are forwarded to the Bureau

of Vital Statistics for permanent filing. This process takes approximately 60 days. If immediate evidence is

required, please contact the Clerk of Circuit Court where the record originated.

Total Amount Enclosed

$4.00

$2.00

$10.00

$1.00

$5.00

$0.00

$1.00

$0.00

$6.00

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DH 260, 01/2022, Florida Administrative Code Rule 64V-1.0131 (Obsoletes Previous Editions)

INFORMATION AND INSTRUCTIONS FOR FLORIDA DISSOLUTION OF MARRIAGE

CERTIFICATE APPLICATION (DIVORCE OR ANNULMENT)

If you need assistance, please contact our Vital Records Section at 904-359-6900 ext. 9000.

A $5 search fee is included in all orders and is non-refundable. If no record is found, a certified “No Record

Found” statement will be issued.

AVAILABILITY: After a dissolution of marriage (divorce or annulment) has been recorded with the Clerk of Circuit Court, the Clerk forwards a report to

the Bureau of Vital Statistics for permanent filing. This process takes approximately 60 days. If the current dissolution of marriage is less than 60 days

from the date of this application and immediate evidence is required, contact the county Clerk of Circuit Court where the dissolution was granted.

Any dissolutions prior to June 6, 1927 are obtainable from the Clerk of Circuit Court in the county where the dissolution was granted. www.flclerks.com.

CERTIFICATE: The Bureau of Vital Statistics issues a Certification of Dissolution of Marriage (Divorce or Annulment) as an abstract of information

taken from the judgment recorded by the Clerk of Circuit Court. The certificate issued generally contains only names, and date and place of dissolution;

and is accepted by all State and Federal Agencies as evidence that a dissolution was finalized and recorded. The complete judgment may be obtained from

the Clerk of Circuit Court in the county where dissolution was granted. Clerk of Court website: www.flclerks.com.

ELIGIBILITY: Dissolution of Marriage Certificates are public record. No identification is required.

UNKNOWN DATE OF DISSOLUTION OF MARRIAGE: If date of event is unknown, the entire year specified will be searched. If the year is

unknown, specify the span of years to be searched (Example: 1990 to 2000) and pay $2.00 for each additional year to be searched. Maximum fee is $50

regardless of number of years to be searched.

REQUIREMENT FOR ORDERING: Applicant must provide a completed application. For events prior to 1970, the name of the husband must be

provided as records were only indexed in this manner. For events from 1970 to present, searches may be conducted by the name of either spouse.

FEES: Check or Money Order Payable to: Vital Statistics. DO NOT SEND CASH. International payments must be made by Cashier’s Check or Money

Order in U.S. Dollars drawn upon a U.S. Bank. Florida Law imposes an additional service charge of $15.00 for dishonored checks. Fees are nonrefundable,

except fees paid for additional copies when no record is found. These may be refunded upon written request.

OPTIONS FOR ORDERING:

CREDIT CARDS: The Bureau of Vital Statistics currently does not accept credit cards by phone or email, if you wish to order by credit card, you may contact

VitalChek, our only approved vendor. VitalChek charges an additional processing fee of $7.00 in addition to a $10.00 rush fee charged by the Bureau of Vital

Statistics. Expedite shipping is available for an additional fee. VitalChek may be reached by telephone at 1-877-550-7330, by fax at 1-877-550-7428, or online at

VitalChek.com. Rush service for current dissolutions less than 60 days ago may not be available.

MAIL IN: Normal processing time is 3-5 business days for computer certificates (1970 to present). Photocopy certificates (prior to 1970) require additional

processing time. If requesting RUSH service mark the outside of your envelope “RUSH”. Rush Orders are given priority processing. Expedite shipping is

NOT included in rush fee. All orders require a $1.00 Shipping and Handling Fee and are mailed Standard U.S. Postal delivery unless a special prepaid express

delivery envelope is provided. Rush service for dissolution of marriage within the last 60 days may not be available.

WALK-IN SERVICE: Visit 1217 North Pearl Street, Jacksonville, Florida, between 8:00 am – 4:30 pm. Photocopy certificates (records prior to 1970)

require the $10 rush fee and may not be available for same day service.

MAIL THIS APPLICATION WITH PAYMENT TO:

FLORIDA DEPARTMENT OF HEALTH

BUREAU OF VITAL STATISTICS

ATTN: VITAL RECORDS SECTION

P.O. BOX 210

JACKSONVILLE, FL 32231-0042

Express Mail and Courier Deliveries to: 1217 North Pearl Street, Jacksonville, Florida, 32202

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