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Single Status Certificate Application

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APPLICATION FOR A SINGLE STATUS CERTIFICATE

Sir/Madam,

Subject: Application for a certificate of my marital status

1. I, __________, son/daughter of __________, born on __________, resident of __________, apply for a certificate of my marital status.

DECLARATION

I declare that what I have stated above is true to the best of my knowledge and belief, and that I have concealed nothing. I will give the office any further paper it asks for. I ask that the certificate be issued to me.

ENCLOSURES

1. Proof of identity, age and address.
2. The decree of divorce or the death certificate, where it applies.
3. An affidavit of my status, if the office asks for one.
4. Passport-size photographs, if the office asks for them.

Signature of the applicant: _______________________
__________

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