Affidavit of Single Status

Affidavit of Single Status of ______

I, ______, of the ______, in the Province of ______, DO SOLEMNLY DECLARE:

1. My date of birth is ______, in ______.

2. I hold Canadian citizenship.

3. My permanent Canadian address is ______.

4. For identification purposes, I present my: ______, ______

5. This affidavit is made to confirm that I am unmarried and legally free to enter into marriage outside of Canada. No legal barriers, prior marriages, or existing partnerships exist that would prevent or impede the marriage.

6. I am currently single and have never been married, or all prior marriages have been legally dissolved.

7. This declaration is made for the purpose of submission to Global Affairs Canada and any other relevant government authority, and for no unlawful or improper purpose.