Diocese of Helena Archives

Sacramental Record Request Form (mail-in)

(One form per request, please print clearly)

Details for sacramental record (*For Matrimony Record Only)

Request Date: _______________

Sacrament (Circle one): Baptism First Communion Confirmation Matrimony Death

Name of Individual on Record: _______________________________________________

Date of Birth: ____________________________________________________________

Name of Parish: __________________________________________________________

City: ______________________________State/Province: ________________________

Date/Year of Rite (if unknown, give approximate): ______________________________

Father’s Name: ___________________________________________________________

Mother’s Name: __________________________________________________________

*Name of Spouse: ________________________________________________________

*Spouse’s Father’s Name: __________________________________________________

*Spouse’s Mother’s Name: _________________________________________________

Additional details/comments: _______________________________________________

Requestor’s Relationship to Person Named in Record (self, guardian, other): __________

Purpose of Request: _______________________________________________________

Contact Information (*required information)

*First Name: ______________________ *Last Name: ___________________________

*Address: _______________________________________________________________

*City: _______________________________ *State/Province: _____________________

*Zip Code: ___________________ Daytime Phone: (________)____________________

*Email: _________________________________________________________________

*Signature_______________________________________________________________

(signature of named recipient of sacrament or authorized recipient of document)

Please make donation payable to the Diocese of Helena

Mail Request Form and Donation to:

Dolores Brinkel, SCL

Archivist

P.O. Box 1729

Helena, MT 59624-1729