Government of Tamil Nadu Registration Department FORM 1-A (RULE 5-A) Application for registration of Marriage at Private Residence on the date of the marriage under "The Madras Hindu Marriage (Registration) Rules, 1967" We, the persons who have signed hereunder as bridegroom and bride hereby apply for the registration of our proposed marriage under the Madras Hindu Marriage (Registration) Rules, 1967 and for that purpose furnish the following particulars: - 1.Full name of the bridegroom : 2.Full name of the father of the bridegroom : 3.Full name of the bride : 4.Full name of the father of the bride : 5.Full name of the guardian in marriage of the bride, if any : 6.Age (date of birth) of the bridegroom : 7.Age (date of birth) of the bride : 8. (a) Occupation of the bridegroom : (b) Occupation of the bride : 9.Permanent place of residence of the bridegroom : 10.Permanent place of residence of the bridegroom : 11.The date of solemnization of the proposed marriage : 12.The Place of solemnization of the proposed marriage. (a) Town or village withfull Address : (b) Taluk : (c) District : Station: Signature: Date: (Bridegroom) (Bride)