MARRIAGE CERTIFICATE. Civil Status Registry Office of Sovetsky district of the city of Nizhny Novgorod

MARRIAGE CERTIFICATE

Citizen________________________________

(last name, first name, patronymic name)

Born on_____________________________

(date, month, year (in figures and words))

Place of birth

(last name, first name, patronymic name)

And

Citizen _________________________________

(last name, first name, patronymic name)

Born on_____________________________

(date, month, year (in figures and words))

Place of birth__________the city of Nizhny Novgorod, Russia__________________

(last name, first name, patronymic name)

Married with registration thereof in the Marriage Register on__________under No.____

Upon the marriage the following surnames were assigned

To the husband

To the wife

Place of registration__________________________

in witness whereof an entry under No. ***was made on ***in the Marriage Register.

Russian

nationality (entered at the wife’s will)

Place of state registration:

Civil Status Registry Office of Sovetsky district of the city of Nizhny Novgorod

Name of the Department/Division of the Civil Status Registry Office

Date of issue ***

Head of the Department/Division of the Civil Status Registry Office /Signature/ ***

I-TH No. ***

/Seal: the Main Directorate of Civil Status Registry Offices for Nizhny Novgorod Region, Civil Status Registry Office of Sovetsky district of the city Nizhny Novgorod/

Goznak Moscow Printing Factory. 1998