Author: DAMIAN
Last saved by: uzivatel
Company: Štátny okresný archív Prešov

MINISTERSTVO VNÚTRA SLOVENSKEJ REPUBLIKY, 
sekcia verejnej správy
Štátny archív v Bratislave 
Križkova 7, 811 04 Bratislava

Žiadosť o vyhotovenie výpisu z matriky
Application for duplicates of the certificates (birth/baptism, marriage, death)

Name and surname/ Meno a priezvisko: ……...................................................................................................................................................
Date of birth/ Dátum narodenia: 
……...................................................................................................................................................
Address/ Adresa trvalého pobytu:
……...................................................................................................................................................
Phone number/Tel. číslo: ............................................email: ..........................................................
ID card number/ passport number/ Číslo občianskeho preukazu alebo iného preukazu totožnosti 
……...................................................................................................................................................
I request copy issued from the parish/ registry office located in/ Žiadam o vyhotovenie výpisu z matriky farského/matričného úradu:
……...................................................................................................................................................
BIRTH/ BAPTIZM/ NARODENÝCH/POKRSTENÝCH:
Name and surname of the newborn/ baptized/ Meno a priezvisko narodeného/krsteného dieťaťa: ……...................................................................................................................................................
……...................................................................................................................................................
Date of birth/ Dátum narodenia: ……...............................................................................................
Place of birth/ Miesto narodenia: ……………………………...…………………………………
Parents/ Rodičia: …………………………………………………………...……………………. ………………………………………………………………………..…………………………….
Religion/ Vierovyznanie: …………………………………………………………………………..

MARRIAGE/ SOBÁŠENÝCH:
Name and surname of the newlyweds/ Meno a priezvisko novomanželov: ……...................................................................................................................................................
……...................................................................................................................................................
Date of wedding/ Dátum sobáša: ……..............................................................................................
Place of wedding/ Miesto konania sobáša: ……...............................................................................
Religion/ Vierovyznanie: ………………………………………………………………………...

DEATH/ ZOMRELÝCH:
Name and surname of the deceased/ Meno a priezvisko zomrelého: ……………………………………………………………………………………….……………..
…………………………………………………..……….…………………………………………
Date of death/ Dátum úmrtia: ……...................................................................................................
Place of death/ Miesto úmrtia: ……..................................................................................................
Religion/ Vierovyznanie: ……..........................................................................................................

I declare that I need the mentioned documents for (select one option)/ Prehlasujem, že uvedené písomnosti potrebujem na (vyberte jednu z možností):
1.    personal use/ súkromné účely
2.    official purposes, restitution purposes/ úradné účely, reštitučné účely
and I will use them solely for the purposes stated above/a budem ich používať len na uvedené účely.

In Bratislava, date  .............................................		   Signature ..........................................