THE FOURTH SCHEDULE

(See Section 13 of the Special Marriage Act - 1954)

Certificate of Marriage

I, Selvam ,Marriage officer,Perumeedu,Idukki hereby certify that on 20th day of May 2019
BURSHAHID VADAKKEPURAM SOUKUMADE S/o KHALID SOUKUMADE
Presently Residing at S K COTTAGE,PADNE P.O,KASARAGOD ,KERALA,INDIA
and ANA RAQUEL CORTE REAL MENDES D/o AMERICO PEREIRA MENDES
Presently Residing at RUA HENRIQUE BARRILAO,RUAS NUMBER
45,3DT,LISBON,PORTUGAL,Appeared before me and that each of them, in my presence
and in the presence of the three witness who have signed hereunder,made the declarations
required by section 11 and that a marriage under the Special Marriage Act - 1954 was
solemnised between them in my presence,Signed Marriage Officer For Perumbedu,Idukki

Bridegroom (Sd/-) : BURSHAHID VADAKKEPURAM SOUKUMADE Groom(Sd/-)

ANA RAQUEL CORTE REAL MENDES

1st Witness (Sd/-) : Rijo Joseph S/o M.O Joseph,Muttamthottil

House,Koratty,Thrissur,Kerala
2nd Witness (Sd/-) : Shyju Varghese S/o Varghese,Maliyakkal
House,,Kodakkara,Thrissur,Kerala
3rd Witness (Sd/-) : Shanto John S/o John,Paduveetil House,choondy,Aluva,Kochi

Date the 20th day of May 2019 Signed Marriage Officer

Corrections :

Prepared By
Reader :
Examiner :
(True Copy)

(Marriage Officer,Perumeedu,Idukki)