Affidavit of Single Status

I. Introduction

I, [Your Name], of legal age, currently residing at Hamilton, VA 20158, do hereby solemnly swear and affirm under penalty of perjury that the following is true and correct to the best of my knowledge and belief.

II. Personal Information

• Full Name: [Your Name]

• Date of Birth: October 10, 2050

• Place of Birth: Hamilton, VA 20158

• Current Address: Hamilton, VA 20158

• Nationality: American

III. Statement of Single Status

1. I hereby declare that I am currently single and have never been legally married to any person under any jurisdiction.

2. There are no legal impediments to my ability to enter into a marriage should I choose to do so in the future.

3. This affidavit is made for the purpose of satisfying the requirements of visa application and for no other reason.

IV. Documentation

To the best of my knowledge and belief, there are no public or private records that would contradict this declaration of single status. Attached herein are pertinent documents to support my declaration:

1. Copy of government-issued ID or passport

2. Birth certificate

3. Any other relevant documents

V. Acknowledgment

I understand that knowingly swearing to false information is an offense punishable by law. I am fully aware of the consequences of providing false information and declare that all statements made in this affidavit are true and accurate.

VI. Signature

By placing my signature below, I affirm that I have read and understood the contents of this affidavit and that the information provided herein is accurate and complete.

[Your Name]

Date: August 31, 2070

VII. Notary Public

Subscribed and sworn to before me this 16th day of August 2070, by [Your Name], who is personally known to me or has produced his/her passport as identification.

Notary Public Name: Randall Pitts

Expiry Date: August 31, 2071

[Notary Seal]

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