"(SAMPLE) STATEMENT OF UNMARRIED"
CH155 11/23/2005 1 Page (SAMPLE) STATEMENT OF UNMARRIED November 23, 2005 To Whom It May Concern: I hereby swear that I am unmarried. I was married on July 19, 1975, but the marriage ended in divorce in December of 1980. I have been single since that time. OR I hereby swear that I am unmarried. I have never married and have remained single. __________________________ Lisa Lofty State of California} } s.s. County of Humboldt } Subscribed and sworn to before me ____________________________, Notary Public, this ________________ day of ______________, 199___ in the State of California. ____________________________________ Notary Public Seal My commission expires ____________________________________