12196380.1.

1c-3 Michael Sowards Law Firm

60 East 42nd Street, Suite
2400 New York, NY 10165

2012196380000011
To: Rick Nagel
Apartment 203
198 Keystone Crescent
Leduc AB T9E 0V2

See Important Information Enclosed

 Municipal Form No. 97 (Form No. 13) (To be accomplished in quadruplicate)
REMARKS/ANNOTATION
12196380.1.2-3

State Of New York, Bronx

OFFICE OF THE CIVIL REGISTRAR GENERAL
CERTIFICATE OF MARRIAGE
Province _________________________________________ Registry No.
City/Municipality ___________________________________
(HUSBAND) (WIFE)
FOR OCRG USE ONLY:
Population reference No.
(first) (middle initial) (last) (first) (middle initial) (last)
Name of Contracting
Parties (Husband)

(age) (age)
Date of Birth/Age
(Wife)

TO BE FILLED UP AT THE
OFFICE OF THE CIVIL
Sex (Male or REGISTRAR
Female
80
Citizenship

Residence
87

Religion

Civil Status 88 90

92 93

94

99

104 105

106 107
Place of Marriage ……………………………………………………………………………
(Office of the/House of/Barangay of/Church of/Mosque of)
108
……………………………………………………………………………………………….
Address
Date: ………………………………….. Time:……………………………..
(day) (month) (year)

THIS IS TO CERTIFY: That I ………………………………………………………………………………………….. 113

and I, ………………………………………………………………………………………..………….., both of legal age, of our own free will
and accord, and in the presence of the person solemnizing this marriage and of the witnesses named below, take each other as
husband and wife and certifying further that we:

have not entered into marriage settlement.

119
have entered into a marriage settlement, a copy of which is hereto attached.

6th
IN WITNESS WHREOF, we signed/marked with our finger print, this certificate in quadruplicate this……………. day
Aug ………………………..
of ……… 2025 , ……………………
RECEIVED AT THE OFFICE OF
THE CIVIL REGISTRAR
………………………………………………………………. ………………………………………………………
(Signature of Husband) (Signature of Wife)
Signature
THIS IS TO CERTIFY: THAT BEFORE ME, on the date and place above-written, personally appeared the above-
Mentioned parties, with their mutual consent, lawfully joined together in marriage which was solemnized by me in the presence
of the witnesses named below, all of legal age. Name in Print

I CERTIFY FURTHER THAT: Title or Position

CN233948338 Issued on ………………………………………...…,

Marriage License No. …………………………. 256 June
Aug 2024
2025 at Date Received
…………………………………………………….in favor of said parties, was exhibited to me.
No marriage license was necessary, the marriage being solemnized under Art ……………of Executive
Order No. 209.

The marriage was solemnized in accordance with the provisions of Presidential Decree No. 1083

……………………………………………………………………………….
(Signature of Solemnizing Officer) To: Rick Nagel
………………………………………………………..
Apartment 203
(Position/Designation) 198 Keystone Crescent
………………………………………………………………………………………………………………………………………...
(Religious Affiliation, Registry No. and Expiration Date, if applicable)
Leduc AB T9E 0V2
WITNESSES Canada
(Print Name and Sign)
……………………………………………… ……………………………………………………

……………………………………………… …………………………………………………….
12196380.1.3-3

OATH OF SOLEMNIZING OFFICER

I, _______________________________________, solemnizing officer, do solemnly swear:

That I have ascertained the qualifications of the contracting parties and have found nolegal
impediment for them to marry as required by Art. 34 of the Family Code;

That this marriage was performed in articulo mortis;

That the residence of one or both of the contracting parties: barangay/barrio/sitio

____________________________(and) __________________________ is
so located that there is no means of transportation to enable the concerned party/parties
to appear personally before the civil registrar;

That the marriage was among Muslims or among members of the ethnic cultural communities,
provided the marriage was solemnized in accordance with their customs or practices;

And that I took the necessary steps to ascertain the ages and relationships of the contracting
Parties and that neither of them are under any legal impediment to marry each other.

………………………………………
Signature of Solemnizing Officer

SUBSCRIBED AND SWORN to before me this ________ day of _______________, ___________,

who exhibited to me his Community Tax No. _____________________________ issued on ___________________
at _________________________________________.

_____________________________________________________________

Signature over Printed Name of Administering Officer whose

Commission Expires on _____________________________

Doc. No. _____________________

Page No. _____________________
Book No. _____________________
Series of _____________________