Municipal Form No. 90 (Form No.

2)
(Revised January 1993)

Registry No. __________________

Date of Receipt _______________
Date of Issuance of
Marriage License ______________

APPLICATION FOR MARRIAGE LICENSE

The Civil Registrar

The Civil Registrar

City/Municipality of ____________________________
Province of __________________________________

City/Municipality of ____________________________
Province of __________________________________

Sir/Madam:
May I apply for a license to contract marriage
with ______________________________ and to this
effect, being duly sworn, I hereby depose and say that I
have all the necessary qualifications and none of the legal
disqualifications to contract the said marriage, and that the
following data are true and correct to the best of my
knowledge and information:

Sir/Madam:
May I apply for a license to contract marriage with
______________________________ and to this effect, being
duly sworn, I hereby depose and say that I have all the
necessary qualifications and none of the legal disqualifications
to contract the said marriage, and that the following data are
true and correct to the best of my knowledge and information:

(First)

(Middle)

(Last)

(First)

(Middle)

(Last)

Name of
Applicant
(Day)

(Month)

(City/Municipality)

(Year)

(Age)

Date of Birth/Age
Place of Birth

(Province)

(Day)

(Month)

(Year)

(Age)

(City/Municipality)

(Province)

(City/Municipality)

(Province)

Sex (Male or
Female)

Citizenship
Residence
Religion
Civil Status
IF PREVIOUSLY
MARRIED:
(City/Municipality)
(Day)

(Province)

(Month)

(Year)

How was it dissolved

Place where
dissolved
Date when dissolve

(Day)

(Month)

(Year)

Degree of
Relationship of
Contracting Parties
(First)

(Middle)

(Last)

Name of father

(First)

(Middle)

(Last)

(First)

(Middle)

(Last)

Citizenship
Residence
(First)

(Middle)

(Last)

Persons who
gave consent or
advice
Relationship
Citizenship
Residence

_________________________

_________________________

(Signature of Applicant)

(Signature of Applicant)
Exempt from

SUBSCRIBED AND SWORN to before me this

______________ day of _______, _________, at

______________________________________
_____________________________, Philippines
________________________________________
(Signature over printed name of Civil Registrar)

documentary
stamp tax

SUBSCRIBED AND SWORN to before me this

______________ day of _______, _________, at

______________________________________
_____________________________, Philippines

________________________________________
(Signature over printed name of Civil Registrar