Archdiocese of San Fernando Pampanga

San Rafael Arkanghel Parish

McArthur Hi-way Mabiga, Mabalacat City, Pampanga

Rev. Fr. Danny Q. Nacpil

Notary on Canonical Books

Archdiocese of San Fernando

Dear Rev. Fr. Danny Q. Nacpil

Acting upon the petition of ______________________________________may i request the

authorization to make changes/correction/inclusion in Baptismal/Confirmation/Marriage Register.

Series of________ Book no._______ Page no.________ Line no.__________

Date of Baptism:_________________________

Wherein the entry/entries should appears as follows

Name: Instead of

Fathers Name: Instead of

Mothers Name: Instead of

Date of Birth: Instead of

Place of Birth: Instead of

Ever willing to abide your decision.

Yours in Christ

Rev. Fr. Venancio D. Viray

Parish Priest