APPLICATION FORM MARRIAGE CERTIFICATE

1 APPLICATION FORM MARRIAGE CERTIFICATE (Under compulsory registration of MARRIAGE Rule, 2012) (Please fill the form in Block Letters) Complete Address of MARRIAGE * Paste Joint Photo of husband and wife, passport size, Both husband wife to sign/thumb impression across their photos Date of MARRIAGE * Bride s Details Groom s Details Name* Father s Name* Mother s Name* Date of Birth * Gender* Female Male Mark of Identity* Mobile No.* Aadhaar No. Email Id Marital Status* Unmarried Married Divorced Widow Unmarried Married Divorced Widower Nationality* Religion* Occupation* Bride s Address Groom s Address Country* State* Permanent Address* Temporary Address It is certified that the information provided above is to the best of my knowledge and belief and nothing has been concealed therein.

2 It is also certified that this MARRIAGE has not been registered anywhere in India/Abroad and we are not related to each other within the degree of prohibited relationship and neither of us is lunatic. We shall be liable for action as per the law, if we have violated any provision of any law of the land. Signature with date: ---------------------------------------- -------------------------------(Wife) ---------------------------------------- ------------------------------(Husband) Witness Details Witness 1 Details Witness 2 Details Witness 3 Details (optional) Name* Father/Husband name* Relation with* Bride Groom Bride Groom Bride Groom Country* Mobile* Aadhaar (optional) Address* Signature* Check List of Requisite Document Required while Applying (Please check against the document being provided while applying) Applicant has to bring original documents for verification and scanning 1 MARRIAGE Entry Form along with Court Fee 2 Joint Affidavit 3 Five Joint Photograph of Husband and Wife( Passport Size and Bride should be on left Side of Groom)

3 4 Residence Proof of both Husband and Wife 5 Identity Proof of both Husband and Wife 6 Date of Birth proof/ Age Proof both Husband and Wife 7 At least three Unique/Distinct postcard size wedding photo 8 Proof of MARRIAGE (Any one In case of registration only) CERTIFICATE from religious institution or priest who solemnized the wedding Nikah Nama CERTIFICATE from Gurudwara / MARRIAGE Card 9 Divorce Decree in case of Divorce 10 Death CERTIFICATE of spouse, in case of widow/widower Date: .. Signature of Applicant : .. Name of Applicant : .. Documentary Proof of Residence Passport Driving License Election Commission Photo ID card Aadhaar Card / E-Aadhaar letter issued by government of India. Domicile CERTIFICATE Documentary Proof of Identity Election Commission Photo ID card Aadhaar Card / E-Aadhaar letter issued by government of India.

4 Driving License Passport Arm s License with Photo Graph Central Government Health Scheme Card or Ex-servicemen Contributory Heath Scheme photo card Applicant's current and valid ration card with Photograph Photo identity card issued by the Central Government or a State Government or a Public Sector Undertaking Pensioner Card having photograph of the applicants CERTIFICATE of identity in original signed by Member of Parliament or Member of Legislative Assembly or a Gazetted Officer containing duly attested photograph Bank CERTIFICATE in original on letter head from the branch (along with name and stamp of the issuing officer) containing duly attested photograph and bank account number of the applicant(Scheduled Public Sector Banks and Regional Rural Banks only) Documentary Proof of Date of Birth Birth CERTIFICATE issued by a Municipal Authority or any office authorized to issue Birth and Death CERTIFICATE by the Registrar of Births & Deaths School leaving CERTIFICATE / Secondary School leaving CERTIFICATE / CERTIFICATE of Recognized Boards from the school last attended by the applicant or any other recognized educational institution Passport Self Affidavit regarding age Medical CERTIFICATE Indicating Age Additional Documents in case APPLICATION is submitted after 90 days of MARRIAGE 1 Late affidavit for registration of MARRIAGE Affix Rs.

5 10 Court Fee Joint Affidavit We _____ S/o _____ R/o of _____ Religion _____ Nationality _____ and _____ D/o _____ R/o _____ of _____ Religion, Nationality _____ Do hereby solemnly affirm and declare as under: -. 1. That we were major at the time of our MARRIAGE and our marital Status was _____ That our MARRIAGE was solemnized on _____ at place _____ as per _____ Rites and Ceremonies. 2.

6 That our MARRIAGE has not been registered anywhere else prior to this APPLICATION 3. That we fulfil the requirements as provided for in Chandigarh compulsory registration of Marriages Rules 2012 and Haryana compulsory registration of marriages Act as applicable to , Chandigarh.. Deponents Verification- Verified that the contents of this Affidavit are true and correct and nothing has been concealed therein. Dated: - Deponents Late Affidavit We_____S/o_____R/o _____ _____Religion_____ Nationality _____and hereby solemnly affirm and declare as under: - 1. That our MARRIAGE was solemnized on _____ at place_____ as per _____ Rites and Ceremonies. 2. That I could not get registered our MARRIAGE on time as we were not aware of new MARRIAGE registration act.

7 1. 2. Deponents Verification- Verified that the contents of this Affidavit are true and correct and nothing has been concealed therein. 1. 2. Dated:- Deponents

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