Email Address (Required)
Fax (Required) :
   
Groom  
Name : 
Nationality :
Place & Date of Birth :
Religion : 
Occupation : 
Local Address (in Bali) :
Permanent Address : 
Have / have not been married before : 
Name of ex-wife : 
Children from previous marriage :
   
Bride  
Name : 
Nationality : 
Place & Date of Birth : 
Religion : 
Occupation : 
Local Address (in Bali) :
Permanent Address : 
Have / have not been married before :
Name of ex-husband : 
Children from previous marriage : 
   
First Witness
Name :
Age :
Religion : 
Occupation : 
Permanent Address : 
   
Father of Groom
Name : 
Age : 
Religion : 
Occupation : 
Permanent Address : 
Mother of Groom  
Name : 
Age : 
Religion : 
Occupation : 
Permanent Address : 
Father of Bride  
Name : 
Age :
Religion : 
Occupation :
Permanent Address : 
Mother of Bride  
Name : 
Age : 
Religion : 
Occupation : 
Permanent Address : 
Second Witness  
Name : 
Age : 
Religion : 
Occupation :
Permanent Address :
   
PREFERRED PLACE & DATE
OF WEDDING CEREMONY :


Required Documents
Copy of Details Page Of Passport (HIS / HERS / WITNESSES)
Copy of Birth Certificate (HIS / HERS)
Copy of Divorce / Death Certificate (if applicable) - (HIS / HERS)
Copy of Baptism Certificate (HIS / HERS)
Photographs of couple together (4 X 6 cm) 5 pieces

Note : Additional items are required for Catholic couples, and this information will be given upon
              request.
              Family such as mothers, fathers, brothers or sisters may not act as witnesses and a copy of
              details page of witnesses passport is also required to be submitted.
 

     

 

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