b (certificate of marriage)
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Municipal Form No. 97 (Form No. 13) (To be accomplished in quadruplicate) (Revised January 1993)
Republic of the Philippines OFFICE OF THE CIVIL REGISTRAR GENERAL
CERTIFICATE OF MARRIAGE
REMARKS/ANNOTATION
Province __________________________________________ City/Municipality ___________________________________
Registry No.
(HUSBAND) (WIFE) Name of Contracting
Parties (first) (middle initial) (last) (first) (middle initial) (last)
Date of Birth/Age (day) (month) (year) (age) (day) (month) (year) (age)
Place of birth
Sex (Male or Female)
Citizenships
Residence
Religion
Civil Status
Name of Father (first) (middle initial) (last) (first) (middle initial) (last)
Citizenship
Name of Mother (first) (middle initial) (last) (first) (middle initial) (last)
Citizenship
Person who gave consent or advice
(first) (middle initial) (last) (first) (middle initial) (last)
Relationship
Residence
Place of Marriage …………………………………………………………………..…………………………….. (Office of the / House of / Barangayof / Council of / Mosque of) ..………………………….….…………………………………………...…………………… Address
Date: ………………….……………. Time: ……………………………..……………. (day) (month) (year)
THIS IS TO CERTIFY: That I …………………….…….……..…..….………....….…………………....……….
and I, ………………………………..…………………................………………., both of legal age, of our own free will and accord, and in the presence of the person solemnizing this marriage and of the witnesses named below, take each other as husband and wife and certifying further that we:
have not entered into a marriage settlement have entered into a marriage settlement, a copy of which is hereto attached.
IN WITNESS WHEREOF, we signed/marked with our finger print, this certificate in quadruplicate this ………….. day of …………………., …………..
…………………………………………………….. …………………………………………………….. (Signature of Husband) (Signature of Wife)
THIS IS TO CERTIFY: THAT BEFORE ME, on the date and place above-written, personally appeared the above-mentioned parties, with their mutual consent, lawfully joined together in marriage which was solemnized by me in the presence of the witnesses named below, all of legal age.
I CERTIFY FURTHER THAT:
Marriage License No. ………………………... issued on ………………………………………..…, at ………………………………………………………… in favor of said parties, was exhibited to me, No marriage license was necessary, the marriage being solemnized under Art. ………..………… of Executive Order No. 1083
TO BE FILLED UP AT THE OFFICE OF THE CIVIL REGISTRAR 80
87
88 90
92 93
94
99
104 105
106 107
108
113
119
RECEIVED AT THE OFFICE OF THE CIVIL REGISTRAR ______________________________ Signature ______________________________ Name in Print ______________________________ Title or Position ______________________________ Date received
FOR OCRG USE ONLY: Population Reference No.
(Husband)
(Wife)
the marriage was solemnized in accordance with the provisions of Presidential Decree No. 103
………………………………………………………………………………………………. (Signature of Solemnizing Officer)
……………………………………………………..
(Position/Designation)
…………………..………………………………………………………………………………………………………………………………… (Religious Affiliation, Registry No. and Expiration Date, if applicable)
WITNESSES
(Print Name and Sign)
…………………………………………………………….. ……………………………………………………………..
…………………………………………………………….. ……………………………………………………………..
OATH OF SOLEMNIZING OFFICER
I, _______________________________, solemnizing officer do solemnly swear:
That I have ascertained the qualifications of the contracting parties and have found no legal impediment for them to marry as required by Art. 34 of the Family Code; That this marriage was performed in articulo mortis; That the residence of one or both of the contracting parties: barangay/barrio/sitio
___________________________________ (and) _____________________________, is so located that there is no means of transportation to enable the concerned party/parties to appear personally before the civil registrar;
That the marriage was among Muslims or among members of the ethnic cultural communities,
provided the marriage was solemnized in accordance with their customs or practices; And that I took the necessary steps to ascertain the ages and relationships of the contracting
parties and that neither of them are under any legal impediment to marry each other. …………………………………………………. Signature of Solemnizing Officer SUBSCRIBED AND SWORN to before me this ______ day of ________________, __________,
who exhibited to me his Community Tax No. __________________ issued on _______________________ at __________________________________________.
Doc. No. ______________ __________________________________________ Page No. _____________ Signature over Printed Name of Administering Officer whose Book No. _____________ Commission Expires on _____________________________ Series of ______________
NOTE – In case of a marriage on the point of death, when the dying party, being physically unable, cannot sign the Instrument by signature or mark, it shall for one of the witnesses to the marriage to sign in his name, which in fact shall be attested by the person solemnizing the marriage as follows:
I HEREBY CERTIFY that the contracting party ………………………………..……………….. being on the point of death and physically unable to sign the foregoing marriage contract by signature or mark, one of the witnesses to the marriage signed for him or her by writing the dying party’s name and beneath it, the witness’ own signature preceded by the preposition ‘By’.
……………………………………………….………
Signature and Printed named of Solemnizing Officer
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