Report Of Marriage - Republic Of The Philippines Department Of Foreign Affairs
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1NOT FOR SALE
REPUBLIC OF THE PHILIPPINES
FORM PRESCRIBED BY FSC 75-94
DEPARTMENT OF FOREIGN AFFAIRS
(REVISED JUNE 2013)
REPORT OF MARRIAGE
DATE OF REPORT
(day-month-year)
OF A PHILIPPINE CITIZEN ABROAD
THIS FORM IS NOT FOR SALE. DO NOT LEAVE ANY SPACES BLANK. INDICATE N/A IF NOT APPLICABLE.
Foreign Service Post: TOKYO, JAPAN
PARTICULARS OF CONTRACTING PARTIES
HUSBAND
WIFE
1. LAST NAME
2. FIRST NAME
3. MIDDLE NAME
4. DATE OF BIRTH
(day-month-year)
5. AGE
6. PLACE OF BIRTH
7. CITIZENSHIP
8. RESIDENCE
9. CIVIL STATUS
(
) SINGLE
(
) DIVORCED
(
) WIDOWER
(
) ANNULLED
(
) SINGLE
(
) DIVORCED
(
) WIDOW
(
) ANNULLED
10. RELIGION
11. OCCUPATION
PARTICULARS OF CONTRACTING PARTIES
HUSBAND’S PARENTS
WIFE’S PARENTS
12. FATHER’S FULL NAME
13. CITIZENSHIP
14. MOTHER’S FULL NAME
15. CITIZENSHIP
16. NAME OF WITNESS 1
17. RESIDENCE
18. NAME OF WITNESS 2
19. RESIDENCE
20. DATE OF MARRIAGE
21. PLACE OF MARRIAGE
22. NAME OF SOLEMNIZING / OFFICIATING OFFICER
N/A
N/A
23. TITLE OF SOLEMNIZING / OFFICIATING OFFICER
We/I solemnly swear under penalty of law that the statements made on this report are true and correct, and the attached supporting documents are authentic; and
Philippine Embassy - Tokyo, Japan
we/I hereby set our hand/s this _________ day of ________________ at _________________________________.
Signature of Husband: _____________________________________________
Signature of Wife: _____________________________________________
EMBASSY OF THE REPUBLIC OF THE PHILIPPINES
The marriage was today registered with the Embassy / Consulate under No. __________________________ of the Civil Registry Book. This report has been executed in a quadruplicate, copy
furnished the contracting parties, copy transmitted to the Department of Foreign Affairs (DFA) in Manila, copy transmitted to the Civil Registrar through the DFA, and copy placed in the files of
this Embassy/Consulate together with the following supporting documents:
(
) MARRIAGE CERTIFICATE
(
) COPIES OF PASSPORTS OF CONTRACTING PARTIES
Date:
__________________________
Doc. No. ________________________
Service No. ______________________
O.R. No. ________________________
Fee Paid: ________________________
Book No. ________________________
SEAL
REPUBLIC OF THE PHILIPPINES
Series of ________________________
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