AFFIDAVIT OF MARRIAGE
STATE OF ________
COUNTY OF ________
§ 1. Affiant. I, ________ (the “Affiant”), residing at ________, being of legal age and competent to make this Affidavit, and being first duly sworn upon oath (or affirmation), do hereby depose and state as follows, of my own personal knowledge.
§ 2. Personal Information. I was born on ________, in ________. My date of birth and place of birth as stated herein are true and correct.
§ 3. Statement of Marriage. I further certify and affirm that on ________, in ________, I was lawfully and ceremoniously married to ________ (the “Spouse”), pursuant to and in compliance with the laws of the jurisdiction in which such marriage was solemnized.
§ 4. Continuing Status. Said marriage was valid at its inception, has not been annulled, dissolved, or otherwise terminated by judgment of any court, and remains in full force and effect as of the date of this Affidavit, except as may be otherwise stated below: ________.
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________
§ 6. Supporting Documentation. A certified copy of the marriage certificate and/or such other documentation as may be available in support of the statements herein is attached hereto or available upon request: ________.
§ 7. Verification and Oath of Affiant. I declare and certify under penalty of perjury under the laws of the State of ________ and the United States of America that I have read and know the contents of this Affidavit signed by me, that the foregoing statements are true, correct, and complete to the best of my knowledge, information, and belief, and that this Affidavit is made for the purpose(s) stated herein and not for any improper or unlawful purpose. I understand that any willfully false statement made herein may subject me to the penalties of perjury and other applicable law.
______________________________
________, Affiant
Date: ________
ACKNOWLEDGMENT / JURAT
STATE OF ________
COUNTY OF ________
Subscribed and sworn to (or affirmed) before me on this ________ day of ________, ________, by ________, who is personally known to me or who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument, and who acknowledged to me that he or she executed the same for the purposes therein contained.
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In witness whereof, I hereunto set my hand and official seal.
______________________________
Notary Public Signature
Printed Name: ________
My commission expires: ________
Commission Number: ________
(Seal)