Immaculate Heart of Mary Parish

580 Ratzer Rd., Wayne, NJ 07470

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Sacramental Records

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  REQUEST FOR SACRAMENTAL RECORDS REQUIRED Baptism Marriage Confirmation First Holy Communion Please fill out this field.
  
  Name as stated on certificate REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Date of sacrament REQUIRED Please fill out this field. Please enter valid data.
  
  Father’s full name Please enter valid data.
  
  Mother’s full name/maiden REQUIRED Please fill out this field. Please enter valid data.
  
  Any other pertinent information Please enter valid data.
  
  Name of person requesting certificate REQUIRED Please fill out this field. Please enter valid data.
  
  Relation: (self, parent, legal guardian, parish office) REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Adress Please enter valid data.
  
  Sacramental Record will be mailed. Allow one week after receipt of request in the parish office for processing.
  
  Email REQUIRED Please fill out this field. Please enter valid data.
  
  Processing Fee10.0
  
  Your additional voluntary donation $ Please enter a positive decimal.
  
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Record notes