§ 15. Duty of town and city clerks. 1. (a) It shall be the duty of
the town or city clerk when an application for a marriage license is
made to him or her to require each of the contracting parties to sign
and verify a statement or affidavit before such clerk or one of his or
her deputies, containing the following information. From party one: Full
name, place of residence, social security number, age, occupation, place
of birth, name of father, country of birth, maiden name of mother,
country of birth, number of marriage. From party two: Full name, place
of residence, social security number, age, occupation, place of birth,
name of father, country of birth, maiden name of mother, country of
birth, number of marriage. Both parties shall also be required to
present to the clerk documentary proof of age in the form of an original
or certified copy of a birth record, a certification of birth issued by
the state department of health, a local registrar of vital statistics or
other public officer charged with similar duties by the laws of any
other state, territory or country, a baptismal record, a passport, an
automobile driver's license, any government or school issued
identification card that contains a photograph of the applicant, a life
insurance policy, an employment certificate, a school record, an
immigration record, a naturalization record, a court record or any other
document or record issued by a governmental entity, showing the date of
birth of such parties. The said clerk shall also embody in the statement
if either or both of the applicants have been previously married, a
statement as to whether the former spouse or spouses of the respective
applicants are living or dead and as to whether either or both of said
applicants are divorced persons, if so, when and where and against whom
the divorce or divorces were granted and shall also embody therein a
statement that no legal impediment exists as to the right of each of the
applicants to enter into the marriage state. The town or city clerk is
hereby given full power and authority to administer oaths and may
require the applicants to produce witnesses to identify them or either
of them and may examine under oath or otherwise other witnesses as to
any material inquiry pertaining to the issuing of the license, and if
the applicant is a divorced person the clerk may also require the
production of a certified copy of the decree of the divorce, or proof of
an existing marriage of parties who apply for a license to be used for a
second or subsequent ceremony; provided, however, that in cities or
towns the verified statements and affidavits may be made before any
regular clerk or designee of the clerk's office.

(b) Every application for a marriage license shall contain a statement
to the following effect:

NOTICE TO APPLICANTS

(1) Every person has the right to adopt any name by which he or she
wishes to be known simply by using that name consistently and without
intent to defraud.

(2) A person's last name (surname) does not automatically change upon
marriage, and neither party to the marriage must change his or her last
name. Parties to a marriage need not have the same last name.

(3) One or both parties to a marriage may elect to change the surname
by which he or she wishes to be known after the solemnization of the
marriage by entering the new name in the space below. Such entry shall
consist of one of the following surnames:

(i) the surname of the other spouse; or

(ii) any former surname of either spouse; or

(iii) a name combining into a single surname all or a segment of the
premarriage surname or any former surname of each spouse; or

(iv) a combination name separated by a hyphen or space, provided that
each part of such combination surname is the premarriage surname, or any
former surname, of each of the spouses.

(4) One or both parties to a marriage may elect to change the middle
name by which he or she wishes to be known after the solemnization of
the marriage by entering the new name in the space below. Such entry
shall consist of one of the following options:

(i) the current surname of the spouse electing to change his or her
name; or

(ii) any former surname of the spouse electing to change his or her
name; or

(iii) the surname of the other spouse.

(5) The use of this option will have the effect of providing a record
of the change of name. The marriage certificate, containing the new
name, if any, constitutes proof that the use of the new name, or the
retention of the former name, is lawful.

(6) Neither the use of, nor the failure to use, this option of
selecting a new surname or middle name by means of this application
abrogates the right of each person to adopt a different name through
usage at some future date.

.....................................

(Optional -- Enter new surname above)

2. If it appears from the affidavits and statements so taken, and from
the documentary proof of age presented, that the persons for whose
marriage the license in question is demanded are legally competent to
marry, the said clerk shall issue such license.

4. Before issuing any licenses herein provided for, the town or city
clerk shall be entitled to a fee of thirty dollars, which sum shall be
paid by the applicants before or at the time the license is issued;
provided, however, that when either of the parties applying for such
license is a member of the armed forces of the United States on active
duty (i) a town or city may not collect that portion of the fee which
would otherwise be transmitted to the state commissioner of health
pursuant to this subdivision and (ii) such town or city may elect to
waive the portion of the fee which the town or city is entitled to. Any
town or city clerk who shall issue a license to marry any persons one or
both of whom shall not be at the time of the marriage under such license
legally competent to marry without first requiring the parties to such
marriage to make such affidavits and statements or who shall not require
the production of documentary proof of age or the procuring of the
approval and consents provided for by this article, which shall show
that the parties authorized by said license to be married are legally
competent to marry, shall be guilty of a misdemeanor and on conviction
thereof shall be fined in the sum of one hundred dollars for each and
every offense. On or before the fifteenth day of each month, each town
and city clerk, except in the city of New York, shall transmit to the
state commissioner of health twenty-two dollars and fifty cents of the
amount received for each fee collected, which shall be paid into the
vital records management account as provided by section
ninety-seven-cccc of the state finance law; provided, however, that no
fee shall be collected on behalf of or paid to the commissioner of
health when either of the parties applying for such license is a member
of the armed forces of the United States on active duty. In any city the
balance of all fees collected for the issuing of a marriage license, or
for solemnizing a marriage, so far as collected for services rendered by
any officer or employee of such city, shall be paid monthly into the
city treasury and may by ordinance be credited to any fund therein
designated, and said ordinance, when duly enacted, shall have the force
of law in such city. Notwithstanding any other provisions of this
article, the clerk of any city with the approval of the governing body
of such city is hereby authorized to designate, in writing filed in the
city clerk's office, a deputy clerk, if any, and/or other city employees
in such office to receive applications for, examine applications,
investigate and issue marriage licenses in the absence or inability of
the clerk of said city to act, and said deputy and/or employees so
designated are hereby vested with all the powers and duties of said city
clerk relative thereto. Such deputy and/or employees shall perform said
duties without additional compensation.

5. Notwithstanding any other provision of this section, the city clerk
of the city of New York, before issuing any licenses herein provided
for, shall be entitled to a fee of twenty-five dollars, which sum shall
be paid by the applicants before or at the time the license is issued
and all such fees so received shall be paid monthly into the city
treasury.