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Form - I

See Rule 5(1)


Application for Registration of Hindu Marriage under the
Tamil Nadu Hindu Marriage (Registration) Rules, 1967

HMA/ONLINE/13822930/2021
31/07/2021

Affix a passport
size photograph of
Husband Wife
both Husband and
Wife here

1. HUSBAND DETAILS
(a) Full Name (As per
HARI RAJ VIJAYA KUMAR
records)

(b) Religion Hindu

(c) Caste -

(d) Age & Date of Birth 28 Years & 15/03/1992

(e) Marital status before the


Bachelor
date of Marriage

(f) Occupation Employee

New no 13, old no 532, Trunk road, Poonamallee, Poonamallee


(g) Permanent Address
Taluk, Tiruvallur District, Tamil Nadu, Pincode - 600056, India

(h) Passport Number L2303858

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1A. Details Of Parents HUSBAND'S FATHER
(a) Name VIJAYAKUMAR M

(b) Religion Hindu

(c) Caste OBC

(d) Age 60 Years, Alive

(e) Occupation Others

New no 13, old no 532, Trunk road, Poonamallee, Poonamallee


(f) Address
Taluk, Tiruvallur District, Tamil Nadu, Pincode - 600056, India

1B. Details Of Parents HUSBAND'S MOTHER


(a) Name INDIRANI V

(b) Religion Hindu

(c) Caste OBC

(d) Age 55 Years, Alive

(e) Occupation Others

New no 13, old no 532, Trunk road, Poonamallee, Poonamallee


(f) Address
Taluk, Tiruvallur District, Tamil Nadu, Pincode - 600056, India

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2. WIFE DETAILS
(a) Full Name (As per
DEEKSHIDA VENKATESAN
records)

(b) Religion Hindu

(c) Caste -

(d) Age & Date of Birth 24 Years & 27/06/1996

(e) Marital status before the


Spinster
date of Marriage

(f) Occupation Home maker

No 11, Singal Office West Street, Anna Nagar, PAMMAL,


(g) Permanent Address Pallavaram Taluk, Chengalpattu District, Tamil Nadu, Pincode -
600075, India

(h) Passport Number U2091804

2A. Details Of Parents WIFE'S FATHER


(a) Name VENKATESAN N

(b) Religion Hindu

(c) Caste -

(d) Age 50 Years, Alive

(e) Occupation Others

No 11, Singal Office West Street, Anna Nagar, PAMMAL, Pallavaram


(f) Address
Taluk, Chengalpattu District, Tamil Nadu, Pincode - 600075, India

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2B. Details Of Parents WIFE'S MOTHER
(a) Name PADMAVATI V

(b) Religion Hindu

(c) Caste -

(d) Age 45 Years, Alive

(e) Occupation Others

No 11, Singal Office West Street, Anna Nagar, PAMMAL,


(f) Address Pallavaram Taluk, Chengalpattu District, Tamil Nadu, Pincode -
600075, India

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5. Other Details
VIJAYAKUMAR M
1. Name and Address of the person who
New no 13, old no 532, Trunk road,
solemnized the Marriage (to be furnished if
Poonamallee, Poonamallee Taluk, Tiruvallur
applicable)
District, Tamil Nadu, Pincode - 600056, India

Yes
2. Whether the Marriage was solemnized-
(a) In accordance with the customary rites and
ceremonies of either parties to the marriage as
required by Section 7 of the Hindu Marriage Act
(OR)
(b)In accordance with Section 7(A) of the Hindu
Marriage Act

No

No, 9
3. Place, namely the Village, Taluk and District Street: AVADI - POONAMALLEE ROAD
where the marriage was solemnized, with full Village: Paruthipattu
address Taluk: Avadi
District: Tiruvallur

4. The Date on which the marriage was


03/03/2021
solemnized

6. We hereby declare :-

(i) that a valid marriage was solemnized between us and that the marriage is capable of being
registered under Section 8 of the Hindu Marriage Act, 1955 (Central Act 25 of 1955)
(ii) that have been satisfied;
(iii) that the particulars given in this application are true to the best of our knowledge and belief.
(iv) that the three witnesses who have signed below were present at the time of solemnization of
the marriage and
(v) no dowry was demanded, given and taken.

Station : Signature of the Husband

Date : Signature of the Wife


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7. Name of the witnesses and their addresses

Sr. No. Name Father's/Husband's name and Address Signature


Wife of VENKATESAN N,No 11, Signal
PADMAVA
1 office west street, Pammal, Chennai -
TI V
600075
VENKATE Son of NARAYANAN,No 11, signal office
2
SAN N west street, pammal, chennai - 600075
Wife of VIJAYAKUMAR M,New no 13, old
INDIRANI
3 no 532, Trunk road, Poonamallee, Chennai
V
- 600056

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