4. A declaration of marriage shall state, in addition to the information required by articles 110, 119 and 120 of the Civil Code, the following additional particulars:(1) the marital status of each of the spouses to be; if either is divorced or widowed, the date of the last divorce or the date of the former spouse’s death;
(2) the place where the birth of each of the spouses was registered; and
(3) the code number assigned to the officiant by the registrar of civil status.