Municipal Form No.

97
(Revised January 2007)
Republic of the Philippines (To be accomplished in quadruplicate using black ink)

OFFICE OF THE CIVIL REGISTRAR GENERAL

CERTIFICATE OF MARRIAGE
Province Registry No.

City/Municipality
HUSBAND WIFE
1. Name of
Contracting
(First) (First)
Parties
(Middle) (Middle)

(Last) (Last)

2a. Date Birth (Day) (Month) (Year) (Age) (Day) (Month) (Year) (Age)
2b. Age

3. Place of Birth (City/Municipality) (Province) (Country) (City/Municipality) (Province) (Country)

4a. Sex Sex

(Citizenship)
Sex
(Citizenship)
4b. Citizenship

5. Residence (House No. Street, City/Municipality, Province, Country) (House No. Street, City/Municipality, Province, Country)

6. Religion/
Religious
Sect
7. Civil Status

8. Name of (First) (Middle) (Last) (First) (Middle) (Last)

Father

9. Citizenship

10. Name of (First) (Middle) (Last) (First) (Middle) (Last)

Mother

11. Citizenship

12. Name of (First) (Middle) (Last) (First) (Middle) (Last)

Person/Wali
Who Gave
Consent or
Advice

13. Relationship

14. Residence (House No. Street, City/Municipality, Province, Country) (House No. Street, City/Municipality, Province, Country)

15. Place of Marriage:

(Office of the/House of/Church of/Mosque of) (City/Municipality) (Province)

16. Date of Marriage: 17. Time of Marriage:
am/pm
(Day) (Month) (Year)
18. CERTIFICATION OF THE CONTRACTING PARTIES
THIS IS 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 entered, a copy of which is hereto attached have not entered into a marriage settlement

IN WITNESS WHEREOF, we have signed/marked with our fingerprint this certificate in quadruplicate this , day of

(Signature of Husband) (Signature of Wife)

19. CERTIFICATION OF THE SOLEMNIZING OFFICER:
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.

a. Marriage License No. issued on , at in favor of said parties, was exhibited to me.

b. no marriage license was necessary, the marriage being solemnized under Art ____________________ of Executive Order No. 209.

c. the marriage was solemnized in accordance with the provisions of Presidential Decree No. 1083.

(SignatureOver Printed Name of Solemnizing Officer) (Position/Designation) (Religion/Religious Sect, Registry No. and Expiration Date, if applicable)

20a. WITNESSES (Print Name and Sign): Additional at the back

21. RECEIVED BY: 22. REGISTERED BY THE CIVIL REGISTRAR

Signature Signature
Name in Print Name in Print
Title or Position Title or Position
Date Date
20b. WITNESSES (Print Name and Sign):

AFFIDAVIT OF SOLEMNIZING OFFICER

I, , of legal age, Solemnizing Officer of with address at
, after having sworn to in accordance with law, do hereby depose and say:

1. That I have solemnized the marriage between and

2.
a. That I have ascertained the qualifications of the contracting parties and have found no legal impediment for them to marry as required by Article 34 of the Family Code.

b. That this marriage was performed in articulo mortis opr at the point of death;

c. That the contracting party/ies and being at the point of death

and physically unable to sign the foregoing certificate of marriage by signature of mark, one of the witnesses to the marriage; sign for him or her by writing the dying party's name and beneath
it, the witness' own signature preceded by the preposition "By";
d. That the residence of either party is so located that there is no means of transportation to enable concerned party/parties to appear personally before the civil registrar;

e. That the marriage was among Muslims or among members of the Ethnic Cultural Communities and that the marriage was solemnized in accordance with their customs and practices;
3. That I took the necessary steps to ascertain the ages and relationship of the contracting parties and that neither of them are under any legal impediment to marry each other;
4. That I am executing this affidavit to attest to the truthfulness of the foregoing statements for all legal intents and purposes.

In truth whereof, I have affixed my signature below this day of , at Philippines.

Signature Over Printed Name of the Solemnizing Officer

SUBSCRIBED AND SWORN to before me this day of , at Philippines, affiant who

exhibited to me his Community Tax Certificate issued on at

Signature of the Administering Officer Position/Title/Designation

Name in Print Address

AFFIDAVIT FOR DELAYED REGISTRATION OF MARRIAGE

I, , of legal age, single/married/divorced/widow/widower, with residence and postal address

, after having duly sworn in accordance with law do hereby depose nad say:

1. That I am the applicant for the delayed registration of

my marriage with in on

the marriage between and in

on .

2. That said marriage was solemnized by (Solemnizing Officer's name) under

a. religious ceremony b. civil ceremony c. Muslim rites d. tribal rites

3. That the marriage solemnized:

a. with marriage license no. issued on at

b. under Article (marriages of exceptional character):

4. (If the applicant is either the wife or husband) That I am a citizen of and my spouse is a citizen of ;

(If the applicant is other than the wife or husband) That the wife a citizen of the husband is a citizen of ;

5. That the reason for delay is registering our/their marriage is ;

6. That I am executing this affidavit to attest to the truthfulness of the foregoing statements for all legal intents and purposes.

In truth whereof, I have affixed my signature below this day of , at Philippines.

Signature Over Printed Name of Affiant

SUBSCRIBED AND SWORN to before me this day of , at Philippines, affiant who

exhibited to me his Community Tax Certificate issued on at

Signature of the Administering Officer Position/Title/Designation

Name in Print Address