Municipal Form 97 h4p3o

Municipal Form No. 97 (Form No. 13) (To be accomplished in quadruplicate) (Revised January 1993) Republic of the Philippines OFFICE OF THE CIVIL REGISTRAR GENERAL

REMARKS/ANNOTATION

CERTIFICATE OF MARRIAGE Province __________________________________________ City/Municipality ___________________________________ (HUSBAND) Name of Contracting Parties

(first)

(middle initial)

Registry No.

FOR OCRG USE ONLY: Population Reference No.

(WIFE) (last)

(first)

(middle initial)

(Husband) (last) (Wife)

(day)

Date of Birth/Age

(month)

(year)

(age)

(day)

(month)

(year)

(age)

Place of birth TO BE FILLED UP AT THE OFFICE OF THE CIVIL REGISTRAR

Sex (Male or Female) Citizenships

80 Residence Religion

87

Civil Status (first)

Name of Father

(middle initial)

(last)

(first)

(middle initial)

(last)

88

90

92

93

Citizenship (first)

Name of Mother

(middle initial)

(last)

(first)

(middle initial)

(last)

Citizenship (first)

Person who gave consent or advice

(middle initial)

(last)

(first)

(middle initial)

(last)

94

99

Relationship Residence

Place of Marriage

Date:

…………………………………………………………………..…………………………….. (Office of the / House of / Barangayof / Council of / Mosque of) ..………………………….….…………………………………………...…………………… Address ………………….……………. Time: ……………………………..……………. (day) (month) (year)

THIS IS TO CERTIFY: That I …………………….…….……..…..….………....….…………………....………. and I, ………………………………..…………………................………………., both of legal age, of our own free will and accord, and in the presence of the person solemnizing this marriage and of the witnesses named below, take each other as husband and wife and certifying further that we:

104

105

106

107

108

113

119

have not entered into a marriage settlement have entered into a marriage settlement, a copy of which is hereto attached.

IN WITNESS WHEREOF, we signed/marked with our finger print, this certificate in quadruplicate this ………….. day of …………………., ………….. ……………………………………………………..

……………………………………………………..

(Signature of Husband)

(Signature of Wife)

THIS IS TO CERTIFY: THAT BEFORE ME, on the date and place above-written, personally appeared the abovementioned parties, with their mutual consent, lawfully ed together in marriage which was solemnized by me in the presence of the witnesses named below, all of legal age. I CERTIFY FURTHER THAT: Marriage License No. ………………………... issued on ………………………………………..…, at ………………………………………………………… in favor of said parties, was exhibited to me, No marriage license was necessary, the marriage being solemnized under Art. ………..………… of Executive Order No. 1083 the marriage was solemnized in accordance with the provisions of Presidential Decree No. 103 ………………………………………………………………………………………………. (Signature of Solemnizing Officer) …………………………………………………….. (Position/Designation) …………………..………………………………………………………………………………………………………………………………… (Religious Affiliation, Registry No. and Expiration Date, if applicable) WITNESSES (Print Name and Sign) ……………………………………………………………..

……………………………………………………………..

……………………………………………………………..

……………………………………………………………..

RECEIVED AT THE OFFICE OF THE CIVIL REGISTRAR ______________________________ Signature ______________________________ Name in Print ______________________________ Title or Position ______________________________ Date received

OATH OF SOLEMNIZING OFFICER I, _______________________________, solemnizing officer do solemnly swear: That I have ascertained the qualifications of the contracting parties and have found no legal impediment for them to marry as required by Art. 34 of the Family Code; That this marriage was performed in articulo mortis; That the residence of one or both of the contracting parties: barangay/barrio/sitio ___________________________________ (and) _____________________________, is so located that there is no means of transportation to enable the concerned party/parties to appear personally before the civil registrar; That the marriage was among Muslims or among of the ethnic cultural communities, provided the marriage was solemnized in accordance with their customs or practices; And that I took the necessary steps to ascertain the ages and relationships of the contracting parties and that neither of them are under any legal impediment to marry each other. …………………………………………………. Signature of Solemnizing Officer

SUBSCRIBED AND SWORN to before me this ______ day of ________________, __________, who exhibited to me his Community Tax No. __________________ issued on _______________________ at __________________________________________.

Doc. No. ______________ Page No. _____________ Book No. _____________ Series of ______________

__________________________________________ Signature over Printed Name of istering Officer whose Commission Expires on _____________________________

NOTE – In case of a marriage on the point of death, when the dying party, being physically unable, cannot sign the Instrument by signature or mark, it shall for one of the witnesses to the marriage to sign in his name, which in fact shall be attested by the person solemnizing the marriage as follows:

I HEREBY CERTIFY that the contracting party ………………………………..……………….. being on the point of death and physically unable to sign the foregoing marriage contract by signature or mark, one of the witnesses to the marriage signed for him or her by writing the dying party’s name and beneath it, the witness’ own signature preceded by the preposition ‘By’. ……………………………………………….……… Signature and Printed named of Solemnizing Officer