MARRIAGE - LICENSE - Application Form
MARRIAGE - LICENSE - Application Form
MARRIAGE - LICENSE - Application Form
(First)___________________________________ (First)___________________________________
1. Name of
(Middle)_________________________________ Applicant (Middle)_________________________________
(Last)___________________________________ (Last)___________________________________
(Day) (Month) (Year) (Age) (Day) (Month) (Year) (Age)
2. Date of Birth/
Age
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
5. Residence
6.
Religion/Religious
Sect
7. Civil Status
8. IF PREVIOUSLY
MARRIED: How was
it dissolved?
13. Citizenship
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
14. Residence
16. Citizenship
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
17. Residence
20. Citizenship
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
21. Residence
_____________________ _____________________
(Signature of Applicant) (Signature of Applicant)
SUBSCIBED AND SWORN to before me this SUBSCIBED AND SWORN to before me this
______________day of _______________,________, at Exempt from ______________day of _______________,________, at
_________________________, Philippines, affiant who exhibited documentary _________________________, Philippines, affiant who exhibited
to me his Community Tax Cert.____________ issued on to me his Community Tax Cert.____________ issued on
_______________________,_____________ at stamp tax _______________________,_____________ at
_________________________________ _________________________________
__________________________ __________________________
(Signature Over Printed Name of the Civil Registrar) (Signature Over Printed Name of the Civil Registrar)