Form D

GOVERNMENT OF MAHARASHTRA
HEALTH DEPARTMENT
MUNICIPAL CORPORATION OF GREATER MUMBAI
MEMORANDUM OF MARRIAGE
Marriage Details

Registration No. : 0050026041

Date of Marriage: 03.12.2014

Ward

: D

Personal Law according to which the marriage between the parties was solemnizes :
MAHARASHTRA REGULATION OF MARRIAGE BUREAUS AND REGISTRATION OF MARRIAGES ACT 1998

Place of Marriage(with full particulars) : SANGH, CHITTAPAVAN BRAHMAN, NIKADWARI LANE,

J S S ROAD, NEAR JAIN HOSPITAL, GIRGAUM, CHARNI ROAD EAST, MUMBAI, 400004,
Maharashtra, India.

Husband Details
Name of the Husband (Full name beginning with surname) : Mr. PAWAR RAHUL DAMODAR

Other names (if any) by which the husband is known :

i. By Birth : Hindu

ii. By adoption (if any) :

Date of Birth & Age as on the date of the solemnization of marriage(Years): 22.01.1987
& 27

Status at the time of marriage (Unmarried/Widower/Divorced): Unmarried

Full address at time of Marriage : 34/I RELE BUILDING, ROOM NO 3/A, MUGBHAT CROSS,
LANE, THAKURDWAR, MUMBAI, MUMBAI, 400004, Maharashtra, India.

Email :krupa.2ds@gmail.com.
Occupation along with office address:Service Workers

Wife Details
Name of the Wife(Maiden Name) (Full name beginning with surname) : Ms. MANE PRITI
YASHWANT

Other names (if any) by which the Wife is known :

i. By Birth : Hindu

ii. By adoption (if any) :

Date Of Birth & Age as on the date of the solemnization of marriage(Years): 12.01.1987
& 27

Status at the time of marriage (Unmarried/Widower/Divorced): Unmarried

Residential address before or at time of Marriage : 19-11 PRADIP BHUVAN, 3RD FLOOR,
1ST SUTAR GALLI, NEAR FADKE MANDIR, GIRGAON, MUMBAI, 400008, Maharashtra, India.

Occupation along with office address:Non workers

Witness 1 Details
Name of Witness 1: Mrs. AISHA EHTESHAMUDDIN KHAN

Relation (if any) with the married couple: SISTER

Address : SAKARWALA BUILDING, 2ND FLOOR ROOM NO 39-B,

ROAD, MUMBAI, 400008, Maharashtra, India.

Occupation along with office address:Non workers

Witness 2 Details
Name of Witness 2 : Mr. EHTESHAMUDDIN NIZAMUDDIN KHAN

70/82 MAULANA AZAD ROAD, DUNCAN

Relation (if any) with the married couple: SISTER HUSBAND

Address : SAKARWALA BUILDING, 2ND FLOOR ROOM NO 39-B,

ROAD, MUMBAI, 400008, Maharashtra, India.

70/82 MAULANA AZAD ROAD, DUNCAN

Occupation along with office address:Service Workers

Witness 3 Details
Name of Witness 3: Mr. ADITYA PRAMOD DHOTRE

Relation (if any) with the married couple: FRIEND

Address : 36/D NARENDRA SADAN, MUGBHAT CROSS LANE,

Maharashtra, India.

GIRGAON,

MUMBAI, 400004,

Occupation along with office address:Service Workers

Priest Details
Name of

Priest: Mr. VISHVASH GOPINATH THAKAR

Religion : Hindu

Age (Years): 55

Address : 7/C, PRITI BUILDING, GR FLOOR,

Maharashtra, India.

Priest's Sign: ____________________________

ROOM NO 10, GHATKOPAR WEST,

MUMBAI, 400060,

Checklist Details
1. Memorandum of marriage Form D details are correctly entered :Yes
2. Proof of age(Attested photocopy of any one of the following)
a. For Bride,18 yrs(completed)
1.
School / College leaving certificate : Yes
2.
Birth certificate
: No
3.
Passport
: No
4.
Domicile
: No
5.
SSC / HSC certificate
: No
b.For Bridegroom,21 yrs (completed)
1.
School / College leaving certificate : No
2.
Birth certificate
: No
3.
Passport
: Yes
4.
Domicile
: No
5.
SSC / HSC certificate
: No

3. Whether residing within the jurisdiction of marriage registrar ?

a. Bride
: No
b. Bridegroom : Yes
4. Proof of residence (Attested photocopy of any one of the following)
a. For Bride
1.
Ration card
:No
2.
Election card
:No
3.
Telephone bill(in the name of person) :No
4.
Electricity bill(in the name of person)
:No
5.
Passport
:No
6.
Adhaar card
:Yes
b. For Bridegroom
1.
Ration card
: No
2.
Election card
: No
3.
Telephone bill(in the name of person) : No
4.
Electricity bill(in the name of person)
:No
5.
Passport
:Yes
6.
Adhaar card
:No
5 Address proof of Witnesses
a. For
1.
2.
3.
4.
5.
6.

Witness 1
Ration card
:No
Election card
:No
Telephone bill (in the name of person)
Electricity bill(in the name of person)
Passport
:No
Adhaar card
:Yes

b. For
1.
2.
3.
4.
5.
6.

Witness 2
Ration card
:No
Election card
:No
Telephone bill(in the name of person) :No
Electricity bill(in the name of person)
Passport
:No
Adhaar card
:Yes

:No
:No

:No

c. For
1.
2.
3.
4.
5.
6.

Witness 3
Ration card
:No
Election card
:No
Telephone bill(in the name of person) :No
Electricity bill(in the name of person)
Passport
:No
Adhaar card
:Yes

:No

6. Copy of wedding card

:Yes
Self declaration if wedding card not produced :
7. Name and sign of the priest

:Yes

8. Passport size photographs of Bride,

Bridegroom
:Yes
9. Divorcee :
:No
Court Decree
a. Divorce certificate (Attested Copy)
b. Court Order (Attested Copy)
:
10. Widower
a. Death Certificate

:No
:

11. Nikahnama
:No
In case both bride and groom are of Muslim religion Nikahnama to be produced (If
Nikahnama is issued in Urdu should be translated in English by the party)
12. If Husband Wife are of different religion then as per the act either Husband or
Wife have to convert his/her religion to match the religion of another to the said
marriage prior to the date of marriage. In this case if one of the parties is
converting himself/herself from his/her own religion (by birth) and adopting religion
of the second party then they should produce following documents (if applicable):
No
a. Affidavit of party on the stamp paper of Rs.100/- :
b. Self affidavit of priest/kazi on the stamp paper of Rs.100/- :
c. Joint declaration on stamp paper of Rs.100/- :

1. Husband

Photograph

1. Paste Photo of
Husband here and
Sign within
box below

3. Witness 1

Photograph

3. Paste Photo of
Witness1 here
and Sign
within box below

2. Wife

Photograph

2. Paste Photo of
Wife here and
Sign within
box below

4.Witness 2 Photograph

4. Paste Photo of
Witness2 here
and Sign
within box below

5.Witness 3 Photograph

5. Paste Photo of
Witness 3 here
and Sign
within box below

Note:
(A) Photos of husband, wife & 3- witnesses must be pasted in the respective box on
the application form.
B) Husband, wife & 3- witnesses are required to do signature on the application forms
only in front of Sub-Registrar.
C) Husband, wife & 3- witnesses all must be present in person in front of
Sub-Registrar on the date of appointment.
D) All required documents original & one set of gazette attested photo copy and the
original application form & receipt must be produced to the Sub-Registrar on the date
of appointment and photo copy set should be submitted to the Sub-Registrar office.
E)Please check your email id Email :krupa.2ds@gmail.com. to view the receipts or
application form or marriage registration certificate.
F)While making final payment to get marriage certificate, applicant must log on to
URL : http://portal.mcgm.gov.in and enter marriage registration no in payment receipt
tab located under path : Citizen Services --> Health Services --> Marriage
Registration.
G)The applicant is hereby requested to recheck the PDF printout of the form for
spelling mistakes & other corrections. If any corrections are required it should be
brought to the notice of the Registrar at the time of appointment along with document
proof wherever necessary.
H)Applicant should note that once the application if approved by the Registrar and
the Marriage Certificate is generated, after that no corrections what so ever will be
made on the Marriage Certificate.