Complete this form and sign electronically. A copy will be sent to Philadelphia Notary & Apostille (contact@philanotary.com) for notarization.
I, [Full Legal Name], being of legal age and being duly sworn, do hereby declare and affirm under penalty of perjury the following:
1. I was born on [Date of Birth] in [Place of Birth].
2. I am a citizen of [Country] and bearer of passport No. [Passport Number].
3. My current address is [Current Address].
4. My civil state is [Civil Status], and currently there is no legal impediment preventing my marriage.
5. I intend to marry [Intended Spouse Name], who is resident of [Residence].
Signature
Date
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF PHILADELPHIA
Sworn to (or affirmed) and subscribed before me by means of ☐ physical presence or ☐ online notarization, this _______ day of __________________, __________, by [Full Legal Name].
Signature of Notary Public
(Seal)
This page will not be notarized and/or included in the apostille package. This is just for record keeping purposes for Philadelphia Notary & Apostille.
Acknowledgement
I acknowledge that this affidavit was self-drafted by me, the affiant. Philadelphia Notary & Apostille does not provide legal advice, immigration services, or representation of any kind, and bears no responsibility for the content, accuracy, or legal sufficiency of this document.
Attestation of Voluntary Execution
I, [Full Legal Name], hereby attest that I have made all of the foregoing statements voluntarily and willingly, that they are true and correct to the best of my knowledge, and that I have signed this affidavit of my own free will, without coercion or undue influence.
Signature of Affiant (electronically signed on submit)
Date
Printed Name