Documente Academic
Documente Profesional
Documente Cultură
16CRS001-4319
Attached is a copy of the revised form for reproduction and dissemination to all
concern.
The use of the revised form shall take effect beginning 01 July 2016.
For compliance
,*~~AO
52016-4319
17'" Fir, CyberPod Cenlris Elan Three, ED5A, Quezon City, Philippines
• Telephone: (632) 375.1604. Email: L.Bersales@psa.gov.ph
www.psa.gov.ph
"
:::'UApplication I-orm
.••.Ri;'vised June 2016
Date
Sir /Madam,
I hereby declare:
at _
(No.) (Street) (Sitio/Barongayj (City/Municipality) (Province)
4.
and my contact number is
_
_
(
,
(Month) (Day) (Year) (City/Municipality) (Province/Country)
5. That I am a member of
--------------------------------
(Nome of Religion! Religious Sect)
(State the title, nome and position of the recommending officer / head of the religion/religious sect)
9. That my religion or religious sect operates in the Philippines and in good repute and I am
assigned to its church, mosque of chapel situated in _
(Name of Church)
10. That I apply for registration as Solemnizing Officer in accordance with Article 7 (2) of the Family
Code of the Philippines promulgated on August 3, 1988 and Administrative Order NO.1, Series
of 2007 and request that an authorization to solemnize marriage be issued to me.
SUBSCRIBED
AND SWORNto before me this __ day of ----- in the city/municipality of
affiant exhibiting his
issued at on _
Doc No. _
Page No, _
Book No.
----
Series of: _