CHRISTIAN MARRIAGE CERTIFICATE APPLICATION FORM

From Name…………………………. Address……………………… ..……………………................. …………………………………. Phone no……………………… To THE REGISTRAR GENERAL OF MARRIAGES, 100, SANTHOME HIGH ROAD, CHENNAI – 600 028. Sir/Madam, I request that ……….. (No. of copies) Copies of Extract of my…………………………. (Relationship to bride/bridegroom) marriage done Under the Indian Christian Marriage Act 1872 as per the following details. 1. NAME OF THE BRIDE GROOM 2. NAME OF THE BRIDE 3. DATE OF MARRIAGE 4. NAME OF THE CHURCH, PLACE & DISTRICT : : : : _ _ / _ _ /_ _ _ _ Ordinary / Correction Affix Rs. 5/Court Fee label

5. NAME OF THE PRIEST WHO SOLEMNIZED THE MARRIAGE 6. CHIRSTIANITY TYPE

: : CSI / R.C

7. ENCLOSE THE XEROX COPY OF : MARRIAGE CERTIFICATE (IF ALREADY RECEIVED FROM THIS OFFICE)

Yes / No

Herewith I am remitting the fee for the same. PLACE : DATE : Yours faithfully, (Signature of the Applicant)
Note: Marriage Certificate should be applied by Bride / Bridegroom / Parents. In case the above mentioned persons are unable to come personally, any one with Authorization Letter from either Bride or Bridegroom can apply.
The marriage certificate may be authenticated with Red Seal from the following office if required: “THE UNDER SECRETARY TO GOVERNMENT, PUBLIC (FOREIGNERS) DEPARTMENT, SECRETARIATE, CHENNAI - 60 0009.”

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