1964_MARRIAGE_REFORM_(FORMS)_REGULATIONS — Page 5

FORM 4

榖格四

APPLICATION FOR REGISTRATION OF VALIDATED MARRIAGE

婚姻註 册申请

MARRIAGE REFORM ORDINANCE, SECTION 9(4) 修訂婚姻制度第九條第(4)

L.N. 39/81.

1981 Ed.]

Marriage Reform (Forms) Regulations

[CAP. 178

C5

[Subsidiary]

ኢ.

#

I hereby apply for the registration of my marriage celebrated in Hong Kong as a modern marriage on the 本人會於 4

day of

19

Particulars of the marriage are described herein.

# # # # # # # * # ##

+

#

#

***#2 # MF:

Names

Condition at the time of marriage 結婚時之婚姻狀況

Age at the time

Rank or Profession at

of marriage

the time of marriage

Residence at the time of marriage

紫鶴時之年齢

結婚時之職階及職業

Names and addresses of Witnesses

at the marriage ceremony

MIHAZM7AN

Date

Annexed hereto is

*the consent of my husband/wife to this application.

* Ad A~# /## A# 2 & #

jay daf

19

as to the subsistance of the marriage.

K A0 W BE 0 MM 02###

*a declaration by the District Court dated the Ju 攀

}

N ỦI J I do solemnly, sincerely and truly declare that all the information given herein is true. ↑ A ¶D WE W ## # # # 2

日期:

19

}

• Delete as appropriate.

將不適用新艷,

ני

B***

Before me.

在本人面前提出聲明

Deputy Registrar of Marriages.

To the Registrar of Marriages, Hong Kong

***M WEB T

Bridegroom:

新郎

* 7,

Bride:

鞍娘

1

1

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FORM 5