Municipal Form 90 (Form No.
2) (To be accomplished in quadruplicate using black ink)
(Revised January 2007) Republic of the Philippines
OFFICE OF THE CIVIL REGISTRAR GENERAL
APPLICATION FOR MARRIAGE LICENSE
Registry No.
Province_____________________________________________
City/Municipality_______________________________________
Received by:______________________________________ Marriage License No.:_______________________________
Date of Receipt:____________________________________ Date of Issuance of Marriage License:__________________
GROOM BRIDE
The Civil Registrar The Civil Registrar
Sir/Madam: Sir/Madam:
May I apply for a license to contract marriage with May I apply for a license to contract marriage with
_______________________________ and to this effect, being _______________________________ and to this effect, being
duly sworn, I hereby depose and say that I have all the duly sworn, I hereby depose and say that I have all the
necessary qualifications and none of the legal disqualifications necessary qualifications and none of the legal disqualifications
to contract the said marriage, and that the following data are to contract the said marriage, and that the following data are
true and correct to the best of my knowledge and information: true and correct to the best of my knowledge and information:
(First)___________________________________ (First)___________________________________
1. Name of
(Middle)_________________________________ Applicant (Middle)_________________________________
(Last)___________________________________ (Last)___________________________________
(Day) (Month) (Year) (Age) (Day) (Month) (Year) (Age)
2. Date of Birth/
Age
(City/Municipality) (Province) (Country) 3. Place of (City/Municipality) (Province) (Country)
Birth
(Male/Female) (Citizenship) (Male/Female) (Citizenship)
4. Sex/Citizenship
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
5. Residence
6.
Religion/Religious
Sect
7. Civil Status
8. IF PREVIOUSLY
MARRIED: How was
it dissolved?
(City/Municipality) (Province) (Country) 9. Place where (City/Municipality) (Province) (Country)
dissolved
(Day) (Month) (Year) 10. Date when (Day) (Month) (Year)
dissolved
11. Degee of
relationship of
contracting parties
(First) (Middle) (Last) 12. Name of (First) (Middle) (Last)
Father
13. Citizenship
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
14. Residence
(First) (Middle) (Last) 15. Maiden name (First) (Middle) (Last)
of Mother
16. Citizenship
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
17. Residence
18. Persons who
gave consent or
advice
19. Relationship
20. Citizenship
(House No., St., Barangay, Province, Country) (House No., St., Barangay, Province, Country)
21. Residence
_____________________ _____________________
(Signature of Applicant) (Signature of Applicant)
SUBSCIBED AND SWORN to before me this SUBSCIBED AND SWORN to before me this
______________day of _______________,________, at Exempt from ______________day of _______________,________, at
_________________________, Philippines, affiant who exhibited documentary _________________________, Philippines, affiant who exhibited
to me his Community Tax Cert.____________ issued on to me his Community Tax Cert.____________ issued on
_______________________,_____________ at stamp tax _______________________,_____________ at
_________________________________ _________________________________
__________________________ __________________________
(Signature Over Printed Name of the Civil Registrar) (Signature Over Printed Name of the Civil Registrar)