How to Fill Out Form DCH-0569-DIV

Form DCH-0569-DIV at a glance

What it is: Application for a certified copy, Michigan divorce record, from the Michigan Department of Health and Human Services.

Who signs: Your Signature must be original in ink, by hand. Enter the Date.

Anyone can request that a search be conducted if the application is completed, signed, and submitted with the required fee paid.

A filled-in Form DCH-0569-DIV example: a divorce record requested by mail

Form DCH-0569-DIV example filled out, example: a divorce record requested by mail
Jane Ann Sample requests a certified copy of a divorce record. Only the divorce year is known, so Month and Day are left blank because they are unknown. The picture shows page 1 only, and every value in it is made up. She searches one additional year, orders one additional copy and pays for rush processing. The signature line has no field, so it is signed by hand in ink.

How to fill out Form DCH-0569-DIV, box by box

Part 1 - Applicant information (person filling out this form)

Form DCH-0569-DIV example filled out, part 1 - Applicant information (person filling out this form)

Part 1 is for the person filling out this form.

Enter the applicant's First Name, Middle and Last name.

Enter the Mailing Address, City, State and Zip.

Enter a Daytime Phone with area code, which is required, and an Email.

Part 2 - Divorce information (to locate record on file)

Form DCH-0569-DIV example filled out, part 2 - Divorce information (to locate record on file)

Part 2 is to locate the record on file.

The names of both spouses and year of divorce are required in order to complete the search. Do not leave these areas blank. If the month and day of divorce are unknown, the entire year you provide is searched. If you need additional years searched, please see Part 5 for fee information.

Enter the Date of Divorce: Month, Day and Year.

For Spouse A, mark Male or Female and enter the Full Name at time of application for Divorce or Annulment: First, Middle and Last.

For Spouse B, mark Male or Female and enter the Full Name at time of application for Divorce or Annulment: First, Middle and Last.

Enter each Parent/Mother's Name and each Parent/Father's Name: First, Middle and Last.

Enter the County where the Divorce or Annulment was granted.

Part 3 - Purpose of request

Form DCH-0569-DIV example filled out, part 3 - Purpose of request

Enter the Purpose of Request in Part 3.

Part 4 - Applicant signature (person filling out this form)

Form DCH-0569-DIV example filled out, part 4 - Applicant signature (person filling out this form)

Part 4 is signed by the person filling out this form.

Your Signature must be original in ink, by hand. Enter the Date.

By signing, I understand I am agreeing to pay for a search of State of Michigan Vital Records. This does not guarantee that a record will be found. Falsifying an application for a vital record and/or assuming the identity of another person is subject to criminal penalties. Per MCL 333.2894(b) and 445.65.

Part 5 - Payment

Form DCH-0569-DIV example filled out, part 5 - Payment

The Application Fee includes one Certified Copy or a No-Find Letter.

Base Fee (Includes one year search) $34.00. Additional Years to Search (If exact divorce year is unknown): Specify Years, $12.00 per year (checked October 30, 2026).

Additional Certified Copies: Specify Quantity, $16.00 each (checked October 30, 2026).

Expedited “Rush” Processing reduces in-office time (does not affect mail time to/from the office): $12.00 additional (checked October 30, 2026).

Pay by check or money order made out to the “State of Michigan”; the request will not be processed if payment is not included in the envelope.

Enter the Total Amount Enclosed.

More rules for Form DCH-0569-DIV

The Michigan Vital Records Office has records of divorces that occurred in Michigan and were filed with the state since 1897. Some records were not filed with the state.

Regular search: approximately 4 to 6 weeks of in-office processing time, depending on volume of requests received. Then sent via regular mail.

If your situation is different

If you need the actual judgement

The State of Michigan will only have the record of divorce. If you need the actual judgement, contact the county where divorce occurred.

Common questions about Form DCH-0569-DIV

Where do I file it?

Mail the application (with check or money order). REGULAR MAIL TO: Vital Records Requests P.O. Box 30721 Lansing MI 48909. RUSH MAIL TO: Vital Records RUSH P.O. Box 30721 Lansing MI 48909. Alternative ordering options, online or phone: to place an order through the authorized service provider, VitalChek, visit www.michigan.gov/vitalrecords or call 866-443-9897.

Sources

[1] Form DCH-0569-DIV (Rev. 02/2025), Application for a Certified Copy, Michigan Divorce Record, Michigan Department of Health and Human Services (the Official source link on this page).

Divorce Or Annulment Michigan Form PDF Details

When it comes to obtaining a copy of a Michigan divorce or annulment record, the process has been made straightforward by the state's Vital Records office. This office holds the records of divorces that have taken place within Michigan and were duly filed with the state since the year 1897, except for a few gaps in the records due to various reasons, such as the missing divorce records for Detroit for the years 1973 and 1974. The form titled "Mail or Counter Application for a Michigan Divorce or Annulment Record" is a crucial document for anyone seeking to request a copy of their divorce or annulment record. The form requires applicants to provide their personal details, including their name, address, and phone numbers, alongside the specifics of the divorce or annulment—such as the names of the husband and wife at the time of divorce or annulment, the date of the divorce or annulment, and the county where it was granted. The document also outlines the costs associated with obtaining the record, including search fees, additional copy costs, and expedited service fees for those needing the information more quickly. With options for both regular and expedited searches detailed, applicants are guided on how to complete their requests effectively, including the turnaround times for processing and the acceptable payment methods. This ensures that individuals seeking information can do so with clarity and understanding of the process involved.

QuestionAnswer
Form NameDivorce Or Annulment Michigan Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdorvoice papers printable michigan, michigan annulment forms, michigan record of divorce, michigan record of divorce or annulment form