Printout and send to the Town of Dexter at the address below.

TOWN OF DEXTER
23 MAIN STREET
DEXTER, MAINE 04930
TEL: (207) 924-7351 - FAX: (207) 924-7352

1. No Vital Record Information may be given over the phone.
2. Non-refundable fees for vital records:

$10.00 Certified Copy
$5.00 each for the same Certified Copy (above) (requested at the same time)
$10.00 per hour for Genealogy Research (fee includes one Certified Copy)
$5.00 minimum charge for Genealogy Research
3. The person making the request must either come in person, fill out the form and pay the fee or send a written request with the payment enclosed.

Date of Request__________________

Name on Record____________________________________________

Date of Event____________________

Type of Record _____Birth _____Death _____ Marriage _____Genealogy Research

Father's Name____________________Mother's Maiden Name____________________

Requested By_______________________________________________

Signature_________________________Address________________________
Relationship_______________________Phone Number___________________
Certified Copies Requested_______________

Genealogy Research Fee_________________

Total Due_______________ Method of Payment_______ Cash_______ Check #_______

Date Paid_______________ Clerk's Initials_______________

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