Marriage Certificate

Husband-to-be

Wife-to-be

Registered Heisei year: _____ month: __ day: __

Husband's Occupation:

Wife's occupation:

Surname:

Surname:

Given name:

Given name:

(How to read) Surname / Given Name:

Date of birth:

Date of birth:

Year: ____ Month: ____ Day: ____

Year: ____ Month: ____ Day: ____

Year: ____ Month: ____ Day: ____

How the wife and husband met, and by chance fell in love:

Husband and wife's occupations:

Husband and wife's occupations:

Additional information:

Registrants' Signatures:

Husband:

Wife:

Photograph or portrait: