City Clerk

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Do you want to Cancel this Application. All of the entered information will be lost.

Domestic Partnership Termination Application

Spanish Translation Guide: Descargue la guía en español (en PDF)

To proceed to the next step, click the "Next" button. At any time, you may return to a previous step by clicking the "Back" button. If you wish to cancel the application at any time, click the "Cancel Application" button at the bottom of the screen.

For complete information on terminating a Domestic Partnership, visit the Domestic Partnership section of the Office of the City Clerk Web site.

Step 1: Information

PARTNERSHIP INFORMATION

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Registration Number (Optional):

Date of Domestic Partnership (MM/DD/YYYY):

Reason to Terminate:

PARTNER 1

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Surname:

First Name:

Middle Name (Optional):

PARTNER 2

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Surname:

First Name:

Middle Name (Optional):

Additional Information

Who will be appearing at the
Office of the City Clerk?

Partner 1

Partner 2

Partner 1 and Partner 2

A copy will be sent by the City Clerk to the non-appearing partner. Please enter the mailing address for the non-appearing partner below:

Street Address:

Apartment Number (If applicable):

Country:

City:

State:

ZIP/Postal Code:

Help - Partnership Information:

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Domestic Partnership Registration Number (Optional):

The registration number on the original Domestic Partnership certificate.

Date of Domestic Partnership:

The date that the Domestic Partnership was officially registered.

Reason to Terminate:

A brief explanation for why the Domestic Partnership is being terminated.

Help - Partner 1:

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Surname:

The first partner's last name. If there is only one legal name, you may enter it in either the "Surname" or "First Name" fields.

Help - Partner 2:

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Surname:

The second partner's last name. If there is only one legal name, you may enter it in either the "Surname" or "First Name" fields.