Immaculate Heart of Mary Parish

8609 Kitcharao, Agusan del Norte

Diocese of Butuan

Jurisdiction Permit

Dear Rev. ___________ ,

Permit is hereby granted to _________________________ for the forthcoming marriage

with __________________________ to be held in your parish on ____________________
please conduct an interview and ask Canonical requirements.

Thank you and God Bless!

_____________________________
Parish Priest

Parish
Seal