Foirm Cl�raithe Psta/Marriage Registration Form

Arna Heisi�int ag / Issued By

Uimhir Leagain / Version Number

D�ta Eisi�na / Date of Issue

Uimhir Fhgra / Notification Number

1: Nta� T�bhachtacha / Important Notes

1. You must take this Marriage Registration Form with you to your marriage ceremony, where section 6 will be completed. Your marriage can not proceed without this form.2. This is NOT your Marriage Certificate. To obtain your Marriage Certificate, this completed form must be brought or posted to any Registrar�s Office within 1 month of the date of marriage.3. An interpreter is required for this marriage ceremony.

2: Sonra� Ph�irt� 1 agus Ph�irt� 2 / Details of Party 1 and Party 2

Ainm / NameSloinne / SurnameSloinne Eile / Other SurnamesD�ta Breithe / Date of BirthSeoladh / AddressN�isi�ntacht / NationalityInsce /SexUimh. PPS / PPS No.Sl� Beatha / OccupationSt�das Psta / Marital StatusAinm & Sloinne Breithe na M�thar /Mother�s Forename & Birth SurnameAinm & Sloinne Breithe an Athar /Father�s Forename & Birth Surname

3: Sonra� an Phsta Bheartaithe / Details of Intended Marriage

D�ta / Date�it / PlaceD� r�ir seo a leanas /According ToFinn� 1 / Witness 1Finn� 2 / Witness 2

Ainm & Seoladh an tSoll�na� /Name & Address of SolemniserSeoladh Todhcha� /Future Address

4: Dearbh� na bP�irtithe sa Phsadh Beartaithe / Declaration of Parties to Intended Marriage

I confirm that I have today received this Marriage Registration Form from, Registrar of Marriages. I confirm that I have read the contents of this form and the details on it are correct to the best of my knowledge.

...................................................................S�ni� Ph�irt� 1 / Signature of Party 1

...................................................................S�ni� Ph�irt� 2 / Signature of Party 2

5: Leasuithe arna nD�anamh L� an Phsta / Amendments on Day of Marriage

This section is only to be used in exceptional circumstances where there is an unavoidable change to some of the details on this form which were given to the Registrar by the parties at the time of the issue of the form. Any such change should be clearly noted on the form and initialled by the Solemniser, the parties to the marriage and both witnesses. In such cases the following should also be completed.

We hereby confirm that this Marriage Registration Form was altered by us on the date of marriage to reflect the following change of details (please specify)-

Change of witness/es (and Date of Birth)

Change of Solemniser

Change of Venue

Change of address of parties

Other (please specify)

6: Le comhl�n� ag bhur searmanas psta / To be completed at your marriage ceremony

The above couple were married at:

on:

This marriage was solemnised by

......................................................................................S�ni� an tSoll�na� / Signature of Solemniser

This marriage was soleminsed between

......................................................................................S�ni� Ph�irt� 1 / Signature of Party 1......................................................................................S�ni� Ph�irt� 2 / Signature of Party 2

In the presence of

......................................................................................S�ni� Finn� 1 / Signature of Witness 1......................................................................................S�ni� Finn� 2 / Signature of Witness 2