DATE

OFFICE OF THE CITY CIVIL REGISTRAR

City Hall of ______________
City of _________________

To Whom It May Concern:

I, ______________________, hereby authorize _______________________ to check

the existence of the marriage license supposedly issued to me and
________________________, the details of which are as follows:

Marriage License No. ________________ issued on __________________ at

_________________________ in favor of _________________ and
____________________.

Thank you.

Sincerely yours,

___________________________