THIS FORM IS NOT FOR SALE

Republic of the Philippines

National Statistics Office
OFFICE OF THE CIVIL REGISTRAR GENERAL

APPLICATION FORM - MARRIAGE CERTIFICATE

IMPORTANT : PLEASE READ GENERAL INSTRUCTION BEFORE FILLING UP THE FORM
Gen.Instruct:Please PRINT letters in the spaces provided. Please CHECK (a) appropriate box(es)
Request for :

MARRIAGE CERTIFICATE

Number of copies:

One

AUTHENTICATION

Two

CDLI

Others (Specify)

: __________

Birth Reference No. of Husband

Birth Reference No. of Wife

BReN (if known)

BReN (if known)

NAME OF HUSBAND
Last Name
First Name
Middle Name
Husband's Tax Identification No.(TIN)

(if known)

MAIDEN NAME OF WIFE

Last Name
First Name
Middle Name
Wife's Tax Identification No.(TIN)
(if known)

DATE OF MARRIAGE
MONTH

DAY

PLACE OF MARRIAGE
City / Municipality
Province
Please specify country if
married abroad only:

REGISTERED LATE?

Country

No

Yes

When:

Check (a) appropriate box

PLEASE TURN TO BACK PAGE

FOR NSO USE ONLY

TRANSACTION NUMBER :

YEAR

PURPOSE : Choose one and check (a) appropriate box

Claim Benefits / Loans

Employment (Local)

Passport / Travel

(Specify Country: _______________ )

Employment (abroad)

(Specify Country: _______________ )

School Requirement
Others (Specify) :
_____________________

REQUESTER'S INFORMATION
Last Name

, First Name

,MI

Mailing Address
House No.

Street Name / Barangay

City / Municipality
Province
Tel. No.

FOR NSO USE ONLY

MONTH

DAY

YEAR

Date of Filing

20

Date of Release

20

Remarks :

Converted ?

For CDLI request only:

CDLI type : _______________________
Proper

: _________ pages

Attachment : _________ pages

Received by

: _____________________________________ Date of receipt : ____________________

THIS FORM IS NOT FOR SALE