One Day Officiant Application

Sundy A Schermeyer
Southampton Town Clerk

Office of the Town Clerk
Town of Southampton 116 Hampton Road Southampton, NY 11968
Telephone (631) 287 - 5740 Fax (631) 283 - 5606

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APPLICATION FOR ONE-DAY MARRIAGE OFFICIANT LICENSE

NOTE: This license is valid only for the stated parties to be married on the date as described within this application and shall expire after the marriage ceremony has taken place. A One Day Officiant License can only be obtained from the Southampton Town Clerk's Office if the marriage license was issued by the Southampton town Clerk's Office.

Applicant is required to return marriage license to the Town Clerk Town of Southampton, 116 Hampton Rd, Southampton, NY 11968 within 5 days after ceremony.

The application and fee must be received at least 2 weeks before the date of the ceremony.

APPLICANT INFORMATION

Applicant Name *

Email Address *

Street Address *

City *

State *

Zip Code *

Phone Number *

Applicant - Date of Birth * +