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Clear Form THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http //www. courts. state. nh. us Court Name Case Name Case Number if known REQUEST FOR CERTIFIED COPY OF DIVORCE DECREE OR VITAL STATISTICS Please send a certified copy of my Divorce Decree 25. The document may also be required for other purposes. I have enclosed a 25. 00 payment for Divorce Decree which covers the cost of the Vital Statistics form as well. Enclosed is a copy of my drivers license or if none other photo identification. I understand that this is needed to obtain a copy of the Vital Statistics form. Date NHJB-2205-F 03/22/2012 Signature Page 1 of 1 Top of Page. 00 and all accompanying paperwork to me at the following address Name Street Address Mailing Address City State Telephone The Vital Statistics Form is required in order to remarry and/or to return to your maiden name after divorce. The document may also be required for other purposes. I have enclosed a 25. 00 payment for Divorce Decree which covers the cost of the Vital Statistics form as well. Enclosed is a copy of my drivers license or if none other photo identification* I understand that this is needed to obtain a copy of the Vital Statistics form* Date NHJB-2205-F 03/22/2012 Signature Page 1 of 1 Top of Page. 00 and all accompanying paperwork to me at the following address Name Street Address Mailing Address City State Telephone The Vital Statistics Form is required in order to remarry and/or to return to your maiden name after divorce. The document may also be required for other purposes. I have enclosed a 25. 00 payment for Divorce Decree which covers the cost of the Vital Statistics form as well.

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