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APPLICATION FOR MARRIAGE LICENSE

City or Municipality of La Trinidad, Province of Benguet

The Local Civil Registrar of La Trinidad

SIR:

I have the honor to apply for a license to contract marriage with Maria Salvo, and to this effect, being duly sworn, I hereby depose and say that I have all the necessary qualifications, and none of the legal disqualifications, to contract the said marriage, and that the following data are true and correct, to the best of my knowledge and information:

(a) Full name of contracting party Rogelio Badua Salviejo

(b) Place of birth San Jose City

(c) Age, date of birth 50 June 30, 1943

(d) Civil status (single, widow or widower, or divorced) widower

(e) If widower or widow, the full name and date of death of the deceased or last deceased spouse Dolores Balauro March 15, 1974

(f) If divorced, how and when the previous marriage was dissolved NONE

(g) Citizenship of contracting party Filipino

(h) Present Residence 41 Brgy Bobonan, Pag., since July 28, 1992

(i) Degree of relationship of contracting parties NONE

(j) Full name of father Matias Salviejo

(k) Residence of father if living Deceased

(l) Full name of mother Salud Badua

(m) Residence of mother if living San Jose City

(n) Full name and residence of guardian or person having charge, in case the contracting party has neither father nor mother and is under the age of twenty years, if a male, or eighteen years, if a female ______________

/s/ R. B. Salviejo
(Signature of applicant)
6th Day of December 1993