CENTRAL ELECTORAL COMMISSION
NATIONAL DIRECTORATE OF CIVIL REGISTRY
THIS IS TO CERTIFY that on the First Day of January, Year Two Thousand and Seventeen (01/01/2017) in the Vital Records Office of the 1ST DISTRICT of VERON the designated CIVIL MARRIAGE was registered in Book No. 00001-A, Page No. 0001, Record No. 000001, Year 2017; the MARRIAGE took place at Hard Rock Hotel, VERON on the First Day of January, Year Two Thousand and Seventeen (01/01/2017)
DOE JOE, citizen of the United States of America, Foreign Passport No. 111111111, son of TIMOTHY JOE and MARIE JOE.
JANE ROE, citizen of the United States of America, Foreign Passport No. 222222222, daughter of DOE ROE and ANN ROE.
1. JOHN JOE, Foreign Passport No. 333333333.
2. ANN ROE, Foreign Passport No. 444444444.
This document is issued at the request of the interested party in VERON Dominican Republic, today on the Second (02) Day of JANUARY Year TWO THOUSAND AND SEVENTEEN (2017)
JUAN JULIO RIJO BOTELLO
VITAL RECORDS REGISTRAR
Ministry of Foreign Affairs
(the Hague Convention of October 5th, 1961)
1. Country Dominican Republic
2. has been signed by Lucrecia Altagracia Martinez Osorio
3. acting in the capacity of OFFICER OF CENTRAL VITAL RECORDS OFFICE
4. bears the seal/stamp of Central Electoral Commission
5. at Santo Domingo 6.Date 01/05/2017
7. by Elizabeth Williams - Assistant Director
8. No. 2017-123456
9. Seal/stamp 10.Signature Signature
Verification code: xxxxxxx
To check the accuracy of this document go to www.mirex.gov.do
If the document is to be used in a country is not a party to the Hague Convention of October 5, 1961, it must be certified at the consulate or embassy.
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