Groom’s Information Sheet

                                                                                                            IMPORTE TOTAL             $____

                                                                                                            ANTICIPO                      $____

                                                                                                            BALANCE                $____

   Name: __________________________________________________________________________

  Nationality: _____________________________________________   Age: __________________

  Where Born:( City, Country and State) ________________________________________________

  Occupation: _________________________________ Religion: _____________________________

  Marital Status (single, divorced, widowed): _____________________________________________

  Residence (City, State, Country): _____________________________________________________

  Mailing Address  : _________________________________________________________________

  Phone: _______________________________

  Father's Name: ____________________________________________________________________

  Where Born:  ________________________________________________  Age: ________________

  Mother's Full Name: ________________________________________________________________

  Where Born: ________________________________________________   Age: _________________

DO NOT WRITE BELOW THIS LINE EXCEPT TO SIGN YOUR NAME

Name__________________________________________

Nationality______________________________________

Where Born _______________________________________ Age______

Residence_________________________________________________

Occupation _______________________________ Married?____________

Phone_______________________

                                                                        __________________________________

                                                                                          Signature of groom

Registrado en________________            Fecha__________________

___________________ Recibo No.___________ Folio No.____________