THIS FORM IS NOT FOR SALE

Republic of the Philippines National Statistics Office APPLICATION FORM CERTIFICATION OF NO RECORD OF MARRIAGE (CENOMAR)
IMPORTANT : PLEASE READ GENERAL INSTRUCTIONS BEFORE FILLING UP THE FORM General Please PRINT letters in the spaces provided. Please CHECK (a) appropriate box(es). Number of copies ? Birth Reference No.
BReN (if known)

OFFICE OF THE CIVIL REGISTRAR GENERAL

One

Two

Others (Specify)

: __________

-

-

-

Sex: Male Female

OWNER'S PERSONAL INFORMATION Last Name First Name Middle Name Date of Birth
MONTH DAY YEAR

Place of Birth
City / Municipality

Province Please specify country if born abroad only:

Country

NAME OF FATHER
Last Name First Name Middle Name

MAIDEN NAME OF MOTHER
Last Name First Name Middle Name
Check (a) appropriate box

REGISTERED LATE?

No

Yes

When:

_________________

Requester's Tax Identification No.(TIN)
(if known)

-

-

PLEASE TURN TO BACK PAGE
FOR NSO USE ONLY

TRANSACTION NUMBER :

Street Name / Barangay City / Municipality Province Tel. No. FOR NSO USE ONLY MONTH DAY YEAR Converted ? Y N Date of Filing Date of Release Remarks : / / / / 20 20 Received by : _____________________________________ Date of receipt : ____________________ THIS FORM IS NOT FOR SALE .MI Mailing Address House No.PURPOSE : Choose one and check (a) appropriate box Claim Benefits / Loans Passport / Travel Employment (abroad) Employment (Local) (Specify Country: _______________ ) (Specify Country: ) School Requirement Others (Specify) : _____________________ REQUESTER'S INFORMATION Last Name . First Name .

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