FORMULARY FOR REQUEST FOR DISPENSATION

FROM PUBLICATION OF BANNS

His Excellency
The Archbishop of Cagayan de Oro
Archbishop’s House
Cagayan de Oro City

ATTENTION: Vicar General

The couple bringing this formulary-request, Mr. __________________________

and Ms._________________________, would like to request for dispensation
from one/two/three publication/s of banns for their coming marriage in the Parish
of St. Joseph the Worker.

Attached herewith is another sheet of paper containing their reason/s for the
requesting the said dispensation.

Sincerely,

___________________________________
Parish Priest/Secretary

Date: __________________

DISPENSATION GRANTED:
Date: __________________