ＦＯＲＭ ＮＯ １０
MUNICIPAL FORM NO.95 (ORIGINAL)
REPUBLIC OF THE PHILIPPINES
QUEZON CITY,METRO MANILA
MARRIAGE LICENSE AND FEE RECEIPT
OF FIFTY PESOS
THIS IS TO CERTIFY that KIICHI TANAKA , aged ** years and
* months, and resident of *********************************,
may legally contract marriage with *********** aged ** years
* months, and resident of *********************************,
he having paid the license fee of P50.00 prescribed under
ＭＭＣ Ordinance No.11, Series of 1986.
This license shall be valid in any part of the Philippines,
but it shall be good for no more than one hundred and twenty
days from the date on which issued and shall be deemed
cancled at the expiration of said period if the interested
parties have not made use of it.
As integral parts of this license, there are herewith
attached copies of the applications of the contracting
parties, and copies of the (Mun.Form No.94),Premarriage
(Family Planning)
Certificate________________________________________________
IN WITNESS WHEREOF, I have signed this license,
this JAN.17 2000
This License is Valld ???:
Until 5-14-2000 cert of legal Capacity
issued by Jpanese
Embassy ?? ?? fc
RAMON M.MATABANG
Register No.*** CIVIL REGISTRAR
QUEZON City,MM
-----------------------------------
City Civil Registrar of Quezon City
Revised per MMC Ord.11,S-86
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INSTRUCTION
If males above 20 but under 25 years of age,or females
above 18 but under 23 years of age, did not obtain
advice of their parents or guardian, or if it be
unfavorble, a note above the signature of the Local
Civil Registrar should be indicated in the following
manner: "Note: The advice upon the intended marriage of
____________________ with __________________________
not having been obtained or having been refused,
the marriage, shall not take place till after three
months following completion of the publication,
on___________________,19____________________________
of the application for the marriage license."
