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1315 Olmstead Avenue
Bronx, NY 10462
718-892-3232
fax: 718-892-7713
sthelenarc@yahoo.com

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For replacement certificates the following information is needed.  
Please complete and return it via e-mail.
 
 
No Request will be completed without
complete address and telephone #

REQUEST FOR SACRAMENTAL CERTIFICATES

     BAPTISMAL CERTIFICATE:  

 1.  First and last name of baptized person:
 2.  DATE OF BIRTH:
 3.  BAPTISM DATE (if known):
 4. Father's name (first and last) :
 5. Mother's name (first and maiden name):

 
CONFIRMATION CERTIFICATE: 
 
1. Full name of person Confirmed:
2. DATE CONFIRMED:
3. Father's name (first and last):
4. Mother's name (first and maiden):

 COMMUNION CERTIFICATE:  

1. Full name of person who received Communion:
2. Date Received Communion:
3. Father's name (first and last):
4. Mother's name (first and maiden):

 MARRIAGE CERTIFICATE:  

1. Full name of husband:
2. Full name (first and maiden) of wife:
3. Date of marriage:

 
Where would you like The certificate  mailed?
Name
Address                     
Apartment #    
City, State,  Zip
No Request will be completed without
complete address and telephone #
 
 

 

 

 

            

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