City Clerk

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

Certificate of Non-Impediment 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 obtaining a Certificate of Non-Impediment, visit the Certificate of Non-Impediment section of the Office of the City Clerk Web site.

Step 1: Basic Info

PERSONAL INFORMATION

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Surname:

First Name:

Middle Name (Optional):

Ethnicity (Optional):

Phone Number (Optional):

Gender:

Date of Birth (MM/DD/YYYY):

Occupation:

CURRENT PLACE OF RESIDENCE

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Street Address:

Apartment Number (If applicable):

City:

State:

ZIP/Postal Code:

Place of Birth

City:

Country:

State:

FATHER

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Surname:

First Name:

Country of Birth:

State of Birth:

MOTHER

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Maiden Surname:

First Name:

Country of Birth:

State of Birth:

Spouse to be (Optional)

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Surname:

First Name:

Middle Name:

Intended Marriage Ceremony

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Date (MM/DD/YYYY):

Country:

City:

Help - Personal Information:

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Surname:

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

Ethnicity (Optional):

The ethnic group to which you most strongly identify.

Help - Place of Residence:

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ZIP/Postal Code:

Only New York City ZIP codes are accepted.

Help - Father:

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Surname:

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

State of Birth:

State only needed if Country selected is United States.

Help - Mother:

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Maiden Surname:

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

State of Birth:

State only needed if Country selected is United States.

Help - Spouse To Be:

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Surname:

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

Help - Intended Marriage Ceremony:

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Date:

The Certificate of Non-Impediment is only valid for six months from the date of issuance.