THIS IS TRANSLATION OF KONIN TODOKE(MARRIAGE REPORT)

TO THE CITY HALL.BY KIICHI TANAKA

　　The REPORT OF MARRIAGE

Date of application (YY) (MM) (DD)

平成１２年　２月　　　２８日

　　　2000 FEB 28

TO THE MAYOR OF SENDAI CITY

NAME ＆

DATE OF BIRTH

HUSBAND WIFE
(LAST) (FIRST)

******* 　*******

 (LAST) (FIRST)

*********　**********

昭和 **　年　*　月　*日

19** JUN **

 昭和　**年　*月　*日

19** SEP **
ADDRESS

(place of resident

registration)

 ************************

AOBA-KU,SENDAI CITY

 *********************

Q .C., PHILIPPINES.
the head of household

******* ********

 the head of household

N/A
PERMANENT

DOMICIL

(foreigner is

Citizenship only)

 ***********************

GUMMA PREF

the head of family

******** **********

 FILIPINO

the head of family

N/A
NAME OF

PARENTS

 FATHER

***** ******

MOTHER

***** ***

 Relation

Ship

1 Son

 FATHER

****** G. **********

MOTHER

****** F. **********

 Relation ship

1 daughter
New family name

And new domicil

 □ TANAKA

□ CONCEPCION

 群馬県 ****************

*******************,

GUMMA PREF,.JAPAN
DATE OF MARRY (Year) (Month)(Day)

平成　１２年　　　２月　　１８日

2000　FEB　18
FIRST MARRY

OR OTHER
  • FIRST MARRY
  • OTHER
  • FIRST MARRY
  • OTHER
    • OCCUPATION Company employee N/A
    OTHER 　 　
    Signature of

    applicant

    		 HUSBAND

    ******** *********

    		 WIFE

    ******** F. *********