Civil Registry Form No.

3A
(Marriage Available)

Republic of the Philippines

OFFICE OF THE CIVIL REGISTRAR
ALAMINOS CITY, PANGSINAN
-oOo-

Certificate of Marriage
_______________________
Date
TO WHOM IT MAY CONCERN:
We certify, among others, the following facts of marriage appear in our Register of
Marriage on Page No. _______________ of Book No. _________________.

HUSBAND WIFE
Name: ___________________________ ____________________________________
Age: _____________________________ ____________________________________
Nationality: ________________________ ____________________________________
Civil Status: _______________________ ____________________________________
Mother: __________________________ ____________________________________
Father: __________________________ _ ____________________________________
LCR Registry Number: _______________ ____________________________________
Date of Registration: _________________ ____________________________________
DATE OF MARRIAGE: _____________ _________________________________________
PLACE OF MARRIAGE: ____________ _________________________________________

This certification is issued to _____________________________________ upon

his/her request.

___________________________
REYNALDO R. CASTRO
City Civil Registrar
Verified by: ___________________________

Amount Paid: …………………………

O.R. Number: …………………………
Date Paid: …………………………….

Note: This certification is not valid if it has mark or erasure or alteration of any entry.