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Municipal Form No. 97 (Form No.

13) (To be accomplished in quadruplicate) REMARKS/ANNOTATION


(Revised January 1993)
Republic of the Philippines
OFFICE OF THE CIVIL REGISTRAR GENERAL
CERTIFICATE OF MARRIAGE

Province __________________________________________ Registry No. FOR OCRG USE ONLY:


City/Municipality ___________________________________ Population Reference No.
(HUSBAND) (WIFE) (Husband)
Name of Contracting (first) (middle initial) (last) (first) (middle initial) (last)
Parties
(Wife)

Date of Birth/Age (day) (month) (year) (age) (day) (month) (year) (age)

Place of birth
TO BE FILLED UP AT THE
OFFICE OF THE CIVIL
Sex (Male or Female) REGISTRAR
Citizenships
80
Residence

Religion
87
Civil Status
(first) (middle initial) (last) (first) (middle initial) (last)
Name of Father
88 90
Citizenship
(first) (middle initial) (last) (first) (middle initial) (last)
Name of Mother
92 93
Citizenship
(first) (middle initial) (last) (first) (middle initial) (last)
Person who gave 94
consent or advice

Relationship 99

Residence
104 105

Place of Marriage ....


(Office of the / House of / Barangayof / Council of / Mosque of) 106 107
.......
Address
Date: .. Time: ...
(day) (month) (year) 108

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
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each other as husband and wife and certifying further that we:

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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 ., ..

.. .. RECEIVED AT THE OFFICE


(Signature of Husband) (Signature of Wife) OF THE CIVIL REGISTRAR
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. Signature
I CERTIFY FURTHER THAT: ______________________________
Name in Print
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.
Title or Position
.. of Executive Order No. 1083 ______________________________
Date received
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
partys name and beneath it, the witness own signature preceded by the preposition By.

.
Signature and Printed named of Solemnizing Officer

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