Form prescribed by FSC

EMBASSY OF THE PHILIPPINES

(Post) BONN/BERLIN

Place & Date of Marriage___________________________________________________

Name & Title of Solemnizing Official___________________________________________

This marriage was today registered at the Embassy, No. _____________ of the Civil Registry Book. This report has been executed in triplicate, copy furnished the contracting parties, copy transmitted to the Civil Registrar General through the Department of Foreign Affairs in Manila, and copy placed in the files of this Embassy together with the following supporting documents:

Copy of Marriage Contract

(Seal)

_______________________________________

Consul of the Philippines

Date:_________________________

( ) Copy for contracting parties

( ) Copy for CRG through DFA

( ) Copy with supporting documents

for Embassy files