Sworn Statement
Affidavit of Single Status
I, [Full Legal Name], being of legal age and being duly sworn, do hereby declare and affirm under penalty of perjury:
1. I was born on [Date of Birth] in [Place of Birth].
2. I am a citizen of [Country] and bearer of passport No. ______.
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].
STATE OF ____________________
COUNTY OF ____________________
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)