Village ............. ........................................................................................................................................
Chief ............... .........................................................................................................................................
and
Name of Wife ..........................................................................................................................................
National Registration No. ........................................................................................................................
Name of Wife’s Guardian .......................................................................................................................
National Registration No. ........................................................................................................................
The said Wife being the* .. ..................................................................................wife and having freely
consented to the marriage.
Consideration paid ..................................................................................................................................
Value .......................................................................................................................................................
Consideration remaining to be paid ........................................................................................................
Value .......................................................................................................................................................
Terms of payment agreed upon ...............................................................................................................
..................................................................................................................................................................
In the presence of ....................................................................................................................................
Given under my hand at ..........................................................................................................................
this ...................... ............. day of...............................................................................................19..........
................................................................................
Customary Marriage Officer
*Here state whether first, second or subsequent wife