Town of Tisbury

Vital Records Request Form

NAME _______________________________

MAILING ADDRESS ______________________________________________

TYPE OF RECORDS REQUESTED:    Birth    Death     Marriage  (circle choice)

NAME OF PERSON ON RECORD ____________________________________

DATE OF EVENT _________________________________________________

Copies requested ______ X $5.00 each =  __________

Amount enclosed = $__________

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INSTRUCTIONS

Print the form, fill it out, and send to the Town Clerk with $5.00 for each copy requested.
Please enclose a Self Addressed, Stamped Envelope.

Please mail to:
    Tisbury Town Clerk
    P.O. Box 606
    Vineyard Haven, Ma. 02568

If you have questions, Please call 508 696-4215