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Report No. 23

The Second Schedule
(See section 12)

Declaration to be made by the Bridegroom1

I, A.B., hereby declare as follows:

1. I am at the present time unmarried (or a widower or a divorcee, as the case may be).

2. 1 have completed years of age.

3. I am not related to C.D. (the bride) within the degrees of prohibited relationship.

4. I am a citizen of.......................................................................................................................

(to be filled up)

5. I am aware that, if any statement in this declaration is false, I am liable to imprisonment and also to fine.

1. Cf. Third Schedule, S.M.A.

Sd. A.B. (the bridegroom)

Declaration to be made by the Bride1

I, CD., hereby declare as follows: -

1. I am at the present time unmarried (or a widow, or a divorcee, as the case may be).

2. I have completed years of age.

3. I am not related to A.B. (the bridegroom) within the degrees of prohibited relationship.

4. I am a citizen of.............................. (to be filled up).

5. I am aware that, if any statement in this declaration is false, I am liable to imprisonment and also to fine.

1. Cf. Fourth Schedule, C.M.B.

Sd. C.D. (the bride)

Signed in our presence by the above named A.B. and C.D. So far as we are aware, there is no lawful impediment to the marriage.

Sd: G.H.,
Witness.

Sd: I.J.,
Witness.

Sd: K.L.,
Witness.

(Countersigned) E.F.
Marriage Officer.

Dated the....................................... day of ...............................19.................................







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