AFFIDAVIT
I, the undersigned, make oath and declare the following personal information regarding my marriage to be held in the city ("Comune") of ______________________________: To be a Canadian Citizen _ by birth _ by naturalization Full name: ___________________________________________________________ Date of birth: ____________________________________ Place of birth: ____________________________________ Last address in Canada: _________________________________________________ Present address: _______________________________________________________ _ _ _ Passport No:______________ issued at ___________on _________________ Birth Certificate no. _____________ date of issuance: ___________________ Citizenship Certificate no._________ date of issuance: ___________________ _ living _ living _ deceased _ deceased
Full name of father: _____________________________ Full maiden name of mother: ______________________ To be: _ single; never previously married and free to marry _ widowed; now free to marry
Indicate full name of spouse and date and place of death: __________________________________________________________ _ divorced; now free to marry Indicate details of ex-husband/wife: __________________________________________________________ Indicate details of final divorce decree: __________________________________________________________ (If minor, attach responsible parents' or legal guardian's consent to the marriage)
I wish to marry the following person, whose details are: Full name: ___________________________________________________________ Date of birth: ___________________________________ Place of birth: ___________________________________ Present address: __________________________________________________
Full name of father: ____________________________ Full maiden name of mother: _____________________ Approximate date of marriage: _____________________
_ living _ living
_ deceased _ deceased
The attached are true “certified copies” of the following documents: • • • • page with photo and signature of my Canadian passport [ ] birth certificate [ ] or Certificate of Canadian Citizenship [ ] Final Divorce Decree [ ] Death certificate of spouse [ ]
__________________________ (Signature) DECLARED and SIGNED before me at _____________________________ this ______ day of ____________ (month & year) ________________________________
(Notary Public or Consular Officer)
WE RECOMMEND THAT YOU PROVIDE YOUR TELEPHONE OR CELLULAR NUMBER. THIS INFORMATION IS HELPFUL SHOULD WE NEED TO CONTACT YOU
Home Telephone Number: Cell phone Number: E-Mail Address:
(______) ______________________ (______) ______________________ ______________________________