Form

Ministry of Internal Affairs

COUNTY NAME

ENTER YOUR EMAIL

GROOM NAME

CELL#

GROOM NATIONALITY

GROOM COUNTY OF ORIGIN

DATE OF BIRTH

CITY/TOWN OF BIRTH

AGE

PLACE OF BIRTH

MOTHER NAME

FATHER NAME

WERE YOU MARRIED BEFORE?

CURRENT ADDRESS

GROOM PASSPORT SIZE PHOTO

BRIDE NAME

CELL#

BRIDE NATIONALITY

BRIDE COUNTY OF ORIGIN

DATE OF BIRTH

CITY/TOWN OF BIRTH

AGE

PLACE OF BIRTH

MOTHER NAME

FATHER NAME

WERE YOU MARRIED BEFORE?

CURRENT ADDRESS

BRIDE PASSPORT SIZE PHOTO

PLACE OF MARRIAGE

DATE OF MARRIAGE

BRIDE PROPOSED MARRIAGE NAME

WITNESS

OFFICIATOR

COST OF CERTIFICATE

WITNESS

OFFICIATOR

COST OF CERTIFICATE

REVENUE NUMBER

DATE