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I desire the marriage to be registered under Foreign Marriage Act 1969. I understand that marriage registered under Section 17 (on registration of foreign marriages) shall, as from the date of registration, be deemed to have been solemnized under this Act. 3. To this effect, I hereby confirm that neither party has a spouse living; neither party is an idiot or a lunatic; the bridegroom has completed the age of 21 years and the bride the age of 18 years at the time of marriage; and the parties are not within the degrees of prohibited relationship. 4. I am aware that, if any of the above statements is false, I am liable to imprisonment and also to fine. Name____________________________________Signature__________________ Full Local Address___________________________________________________ Email _________________________________ Tel. No. ________________________Nationality__________________________ Signed in our presence by the above named_______________________________ _____________________________________________so far as we are aware there is no lawful impediment to the marriage. Witness S. No.NamePassport No.Date of IssuedPlace of IssueSignature ┬─╞ЁЄ " $ , . 0 ┤ ╢ B D ╬ ╨ 6 8 @ B D Ф Ц Ш ▄ ▐ ,. 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