Municipal Form No

Municipal Form No. 90 (Form No. 2) Registry No. ______(Revised January 1993) Date of Receipt ______Date of Issuance of Marriage License ______APPLICATION FOR MARRIAGE LICENSE The Civil Registrar The Civil Registrar City/Municipality of ______City/Municipality of ______Province of ______Province of ______

Sir/Madam: Sir/Madam: May I apply for a license to contract marriage May I apply for a license to contract marriage with with ______and to this effect, ______and to this effect, being being duly sworn, I hereby depose and say that I have all duly sworn, I hereby depose and say that I have all the the necessary qualifications and none of the legal necessary qualifications and none of the legal disqualifications disqualifications to contract the said marriage, and that the to contract the said marriage, and that the following data are following data are true and correct to the best of my true and correct to the best of my knowledge and information: knowledge and information: (First) (Middle) (Last) (First) (Middle) (Last) Name of Applicant

(Day) (Month) (Year) (Age) Date of Birth/Age (Day) (Month) (Year) (Age) (City/Municipality) (Province) Place of Birth (City/Municipality) (Province) Sex (Male or Female) Citizenship Residence Religion Civil Status IF PREVIOUSLY MARRIED: How was it dissolved (City/Municipality) (Province) Place where dissolved (City/Municipality) (Province) (Day) (Month) (Year) Date when dissolve (Day) (Month) (Year) Degree of Relationship of Contracting Parties (First) (Middle) (Last) Name of father (First) (Middle) (Last) Citizenship Residence (First) (Middle) (Last) Persons who gave (First) (Middle) (Last) consent or advice Relationship Citizenship Residence

______(Signature of Applicant) (Signature of Applicant)

Exempt from SUBSCRIBED AND SWORN to before me this documentary SUBSCRIBED AND SWORN to before me this ______day of ______, ______, at ______day of ______, ______, at ______stamp tax ______, Philippines ______, Philippines

______(Signature over printed name of Civil Registrar) (Signature over printed name of Civil Registrar