Affidavit of Single Status

I,

(Full Name), of legal age, residing at

, being duly sworn, depose and say:

1. That I am currently single and have never been married / am legally free to marry.

2. That, to the best of my knowledge, there is no legal impediment to my intended marriage.

3. That this affidavit is made to attest to my single status for all legal intents and purposes.

Subscribed and sworn to before me on this

day of

,

at

.