PEOPLE’S COMMITTEE SOCIALIST REPUBLIC OF VIETNAM Form BTH/HT-2006-KH.

1
Commune/Ward Independence - Freedom - Happiness No.:
Book No.:
District
Province/City

MARRIAGE CERTIFICATE
(ORIGINAL)
04/2006 (Circular No. 01/2006/QĐ-BTP) XBTP

Husband’s full name: Wife’s full name:

Date of birth: Date of birth:
Ethnic group: Nationality: Ethnic group: Nationality:
Permanent/temporary residence: Permanent/temporary residence:
ID Card No./Passport No.: ID Card No./Passport No.:

Husband’s signature Wife’s signature

(Signed) (Signed)

ON BEHALF OF PEOPLE’S COMMITTEE

REGISTRAR CHAIRMAN
(Signed) (Signed and sealed)

……………………. …………………….