‘Murigpal Fom No. 97 Repl of he Phipgnes _ ToD accnplabedn gunning Hock] (Farad gt 2018) OFFICE OF THE CIVIL REGISTRAR GENERAL Registry No, Province = a - City/Municipality : HUSBAND al ee 4.nemeot ay) len Cores | mse) 2a. Date of Binh sy) went) ea) ae) ‘mn ‘won ear) oe) 20. hoe oe ec vas 7 ginny | rome ‘Comey ‘erynnceay) Proves) ‘Canen) a.Placeotemn | foun : fa sex ema) ear 48, Gttzenshin ia a om hss NSB Bara Cini, Pave: Cais) | ——RSase War Si Brgay GAR, Pas, Cao) 5. Residence : ner 6 Religion’ Religious Sect 7-cmi Sas & Name of Fe ose) co Tt waaay car Pater 3 Cazersnip 10 Maiden Name rea was on Feat ee) (sy ofnciner 1. Clizenship a peearao Feat wae) = ey ‘me tap 13, Relationship ‘nse Wo Bs arngey. Givianicety, Prove, Carin) | (owe Na, SE Barony. Cnty, Pine, County) 14. Rescence 15. Ploce of Merge: oP: ofice otaioubeciarangay’ ich ihdosqu oi") ‘Pinca le. Date of mariage 17. Te of Mariage _erven ‘ayy 18. CERTIFICATION OF THE CONTRACTING PARTIES THs to 70 CENTIY: Tha nd 1 ban of lect ace, of ur ow re ht and accor and In he presence of he person slonnzing bit marge an af the wines red blow, he each ther [shusbend and wie and centyg rer ihat we: ‘have ele, copy af his ecto atached/ rave retonares into a marge stent IN WITNESS WHERE. we have ane inared th cur geri hs ert in qundrptcle hie. oy of i ‘Si or isn) (Signatur of vie) 49, CERTIFICATION OF THE SOLEMNIZING OFFICER: THIS IS TO CERTIFY: THAT BEFORE ME, on the date and place above-writen, personally appeared the above-mentioned partis, with thaie mutual congent, lew joned together i maage which was soleized by me in te prosence ofthe witnesses named Delow, alo legal age | CERTIFY FURTHER THAT: ‘8 Marriage License No ‘ssved on at Ih favor of sid partes, was exhibited to me no mariage lense was necessary, the mariage being solemnized under Art......of Exeouwe Order No, 208. the mamage was tlemrized in accordance wth the provlons of Presidential acres No. 1083 (Gionatre Ove Printed fame of Solemizing Ofice”) (ostioniDesignation) (ReigionReigous Sect Regi ait |20a. WITNESSES (Print Name and Sign}: . Algona a ba base No.and Expaten isyeane [PiRECENED BY Ss 72. REGISTERED AT THE OFFICE OF THE CIV REGISTRAR Signature Signature Name ip Pant Name in Pit “Tie or Poston Tie 0 Poston me ate "REMARKSIANNOTATIONS (For LOROIOGRG/Sharl'a Circult Registrar Use Only) “TO BE FILLED-UP AT THE OFFICE OF THE CIVIL REGISTRAR rar) sw ™ oe ew mH ow2b, WITNESSES (Print Name and Sion: AFFIDAVIT OF SOLEMNIZING OFFICER \ i of legal age, Sclemnizing Oicer of with address at Tatar naving sworn tin accordance wth law, do hereby depose and say 4. That | fave solitons tha mbringe baboon =f = nt 3 Tor thet 1 have ewverdined the qualfcaions of the contacting partes and have ound no logal impediment fr them t2 nary as requted by Arce 34 ofthe Fay Code bi. That this mariage ws performed in artgulo mots or at the point of death fa anette |paron eae aD ot sree anvecan’ [nthe te Sign the Rrepaing cericate of marrage by signatire or ark, ove of the winessee to the rartape: sgn dae one rey wrkay the ding partys name and beneath 8 te winess’ own signaiure preceded by the preposition “BY «Tha the residence of either party i 30 loeted that there is no means of transportation to ensble concemed paryparias to appear ovtonany bore the! cll eps, «Tat the mariage wes among Musims of among members ofthe Ethnic Culral Communies and thatthe marioge was slemvized Tccordance wh te customs and practoes 4. Thal ook the necessary ste 1 ascertain the apes end relationship ofthe contracting parties and that neither of them are under any legal Impaciment to marty each other, 4, That | am exeoutng this afidayt to atest to he truhfuness of the foregoing sttements fr al egal inents and pazposes In truth whereof, | have affixed my signature below this Philippines. day of a a ee ‘Signature Over Printed Name ofthe Sclomniing Ofer SUBSCRIBED AND| SWORN to before me this ay of Philippines, affant who exhibited to me hisiher CTC! vali ID leaved on T ot eee ‘Signature ofthe Administering Offcer Poston TitelDesignation Namein Pit Address AFFIDAVIT FOR DELAYED REGISTRATION OF MARRIAGE of legal ago, singletmarrieddvoreaiwidowrwisower, wih residence and postal address ‘iter having duly ewom In accoraance wit) law do hereby depose and say 1. That | am he aplzant for tp delayed registration of ny marioge with the marriage betwoen) 2. That eid marriage was solemnizes by (Golemizing Offcor's name) under & []otoaie aany 2. [Je erenany «:[T] sites o [] we ‘3. That he mariage was solemized Je. with mamage icone no. __issued on eb sa bund Arce mariages of exceptional characte) 4. (the applicant is either the wife or husband) Th | am a cizen of fad my spouse Is a ciizen of (fe applicant othr ta te wile or husband) That the wife is a ctizen of fd the husband ts a etizen of | ‘5, That the reason forthe delay in registering. ourthir marriage Is 6, That | am executing this afd lo ales othe tuthtuness of the foregoing statements for al lgal intents and purposes In truth whereof, have affixed my signature bolow this ay of Phitippines | ‘Signature Over Printed Name of Affant ‘SUBSCRIBED AND SWORN to before me this __day of it Philippines, affiant who exhibited to me his/her CTCivalid ID Issued on at ‘Signature of the Administering Oficer Position! Tite Designation | | ire [=e