FORM 'II'

(See sub-rule 5(1)(a))

Application for Filling Memorandum of Marriage

To,
The Registrar of Marriages,
Pollachi
Sub: Registration of marriage.
Sir,
A marriage has been solemnized between us on 01/01/2019 at NALLIKKAUNDAR LAY OUT
and we request that the particulars of our marriage be entered in the Register of Marriages and
that a Certificate of Registration of Marriage be issued to us.

We hereby declare,
(1) That a valid marriage was solemnized between us and that the marriage is capable of being
registered under section 3 of the Tamil Nadu Registration of Marriages Act, 2009.
(2) That the conditions laid down in our Personal Law have been satisfied.
(3) That the particulars given in application are true to the best of our knowledge and belief.
(4) That a memorandum of marriage duly filled in (in duplicate) along with the prescribed fees and
documents, is enclosed.

Place:
Signature of Husband

Date:
Signature of Wife

Encl:
1. Memorandum of Marriage
2. Prescribed Fees
3. Other Documents (a)___________________________________________
(b)___________________________________________
(c)___________________________________________
Conditions:
1. 2 Sets of Copies should be presented.
2. All Enclosures should be attested by gazetted officer (or) Notary Public.

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 APPENDIX-II
FORM - I
See Rule 5(1)(a)
Memorandum for Registration of Marriage

TMA/ONLINE/15775078/2022
04/01/2022

1. HUSBAND DETAILS
(a) Full Name (As per
TAMILARASAN T
records)

(b) Religion Hindu

(c) Age & Date of Birth 29 Years & 30/03/1989

(d) Marital status before the

Bachelor
date of Marriage

(e) Occupation Employee

50/32, NALLIYAPPAN LAY OUT, UTTHUKADU ROAD, POLLACHI.,

(f) Permanent Address Pollachi Taluk, Coimbatore District, Tamil Nadu, Pincode - 642001,
India

1A. Details Of Parents HUSBAND'S FATHER

(a) Name R THIYAGARAJAN

(b) Age 50 Years, Alive

50/32, NALLIYAPPAN LAY OUT, UTTHUKADU ROAD, POLLACHI.,

(c) Address Pollachi Taluk, Coimbatore District, Tamil Nadu, Pincode - 642001,
India

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 1B. Details Of Parents HUSBAND'S MOTHER
(a) Name T VIMALA

(b) Age 45 Years, Alive

50/32, NALLIYAPPAN LAY OUT, UTTHUKADU ROAD, POLLACHI.,

(c) Address Pollachi Taluk, Coimbatore District, Tamil Nadu, Pincode - 642001,
India

2. WIFE DETAILS
(a) Full Name (As per
R SOUNDARI
records)

(b) Religion Hindu

(c) Age & Date of Birth 38 Years & 05/04/1980

(d) Marital status before the

Spinster
date of Marriage

(e) Occupation Employee

12/1 BLOCK NO 13, MORAISE AVENUE, UDAYANPATTI, TRICHY,

(f) Permanent Address Thiruchirapalli-West Taluk, Thiruchirappalli District, Tamil Nadu,
Pincode - 620021, India

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 2A. Details Of Parents WIFE'S FATHER
(a) Name RAMACHANDARA

(b) Age 60 Years, Alive

12/1 BLOCK NO 13, MORAISE AVENUE, UDAYANPATTI, TRICHY,

(c) Address Thiruchirapalli-West Taluk, Thiruchirappalli District, Tamil Nadu,
Pincode - 620021, India

2B. Details Of Parents WIFE'S MOTHER

(a) Name SARASU

(b) Age 50 Years, Alive

12/1 BLOCK NO 13, MORAISE AVENUE, UDAYANPATTI, TRICHY,

(c) Address Thiruchirapalli-West Taluk, Thiruchirappalli District, Tamil Nadu,
Pincode - 620021, India

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 3. Other Details
R THIYAGARAJAN
1. Name and Address of the person who
50/32, NALLIYAPPAN LAY OUT, UTTHUKADU
solemnized the Marriage (to be furnished if
ROAD, POLLACHI., Pollachi Taluk, Coimbatore
applicable)
District, Tamil Nadu, Pincode - 642001, India
NALLIKKAUNDAR LAY OUT
2. Place, namely the Village, Taluk and District Street: UTTHUKKADU ROAD
where the marriage was solemnized, with full Village: POLLACHI.
address Taluk: Pollachi
District: Coimbatore
3. The Date on which the marriage was
01/01/2019
solemnized
4. Whether the marriage was previously registered
No
under any other Act or Personal Law

4. We hereby declare :-

(i) that a valid marriage was solemnized between us and that the marriage is capable of being
registered under section 3 of the Tamil Nadu Registration of Marriages Act, 2009;
(ii) that the conditions prescribed in the respective personal laws intended for the solemnization of
marriages have been satisfied;
(iii) that the particulars given in this memorandum are true to the best of our knowledge and
belief;
(iv) that the two witnesses who have signed below were present at the time of the solemnization
of the marriage; and
(v) that no dowry was demanded or given or taken.

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 Thumb Impression of
Husband Photo the Husband Signature of the Husband

Thumb Impression of
Wife Photo the Wife Signature of the Wife

Station:
Date :
Signature of the Priest

5. Name of the witnesses and their addresses

Father's/Husband's name and

Sr. No. Name ID Details Signature
Address
Wife of
PRAKASH,8/23,SOUTH
SHOBAN THIROWPATHI AMMAN Uidai-Aadhaar-
1
A P SANNATHI 860175915848
STREET,PUTHUR,TIRUCHIRA
PPALLI-620017
Daughter of M
GANESAN,221, SOWMIYA
ANITHA Uidai-Aadhaar-
2 NAGAR, INNAM
G 503925942806
SAMAYAPURAM,TIRUCHIRAP
PALLI-621112