Single Status Affidavit
This document certifies that the undersigned individual is currently not married. It is intended for use where proof of single status is required. Please fill in all the relevant details where indicated.
State-Specific Declaration: If this affidavit is to be used or filed within a specific state that requires acknowledgment according to local laws, please ensure to comply with those requirements. For State of ____________, reference to the specific state law (State Name) Marital Status Certification Act may be applicable.
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Affidavit of: ____________________________
(Full Name of Affiant)
Date of Birth: ___________________________
(Month/Day/Year)
Place of Birth: ___________________________
(City, State, Country)
Current Residential Address: _______________
__________________________________________
(Street, City, State, Zip Code, Country)
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I, ____________________, solemnly swear and affirm that I am legally single, which means I am not currently married, nor am I a part of any legal domestic partnerships or civil unions. I declare that I have never been married, or if previously married, I have been legally divorced and the marriage has been formally dissolved.
My last marriage (if applicable) was officially dissolved on _____/_____/_____ by __________________________.
(Date of Finalization) by (Name of Court)
This affidavit is made in good faith for the purpose of _______________________.
(Purpose of the affidavit)
I understand that providing false information within this affidavit subjects me to penalties under the laws governing false statements and perjury.
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Affiant's Signature: _______________________
Date: ____________
Notary Public:
State of: ____________
County of: ___________
On this ___ day of ___________, _____, before me personally appeared ______________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
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Notary Signature: _________________________
Seal: