APPLICATION FOR MARRIAGE CERTIFICATE / MARRIAGE TEOR

Name of the Applicant: ________________________________________

Address: ____________________________________________________
Date: _______________________________________________________
Mobile Number: ______________________________________________

To,
The Civil Registrar-cum-Sub Registrar,
____________________________.
Sub: Request to Issue Marriage Certificate / Marriage Teor.

Sir / Madam,

It is kindly requested to issue the Marriage Certificate / Marriage Teor, the details of which
are furnished below:-
1. Groom Name: _____________________________________________________

2. Bride Name:- ______________________________________________________

3. Marriage Registration No.: ____________________________________________

4. Date of Registration : ________________________________________________

5. Date of Marriage: ___________________________________________________

6. Church Name (in case of Canonical Marriage): ____________________________

Yours faithfully,

Signature: ________________

Name: ___________________

For Office use:

Paid Rs. ________ vide Receipt No. ________, Dated: _______

Remarks of dealing Clerk:_________________________________