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Affidavit (for a marriage “Nulla Osta”)

I, the undersigned, make oath and declare the following information regarding my marriage to be held in the city ("Comune") of ______________________________ approximately on the _____ day of ______________, 20___:

1. that I am a Canadian Citizen

__ by birth OR

__ by naturalization


2.that I am the bearer of Canadian Passport number _____________ issued at _______________ on ___ / ___ / 20___, where my personal information appears as follows:

Last name(s): __________________________________

Given name(s): __________________________________

Date of birth: __________________________________

Place of birth (city and country): __________________________________


3. that my parents are/were:

Father’s last name(s): __________________________________

Father’s given name(s): __________________________________

__ living __ deceased

Mother’s last name(s) at birth (maiden): __________________________________

Mother’s given name(s): __________________________________

__ living __ deceased


4. that my current residential address is:

_____________________________________________________________________

_____________________________________________________________________


5. that, if different, my last address in Canada was

_____________________________________________________________________

_____________________________________________________________________


6. that I am the holder of the long-form Canadian birth certificate no. ________________ issued by the Province/Territory of ________________ on ___ / ___ / _____

OR

that I am the holder of the Certificate of Canadian Citizenship number __________________ issued on ___ / ___ / _____


7. that I am free to marry as I am

__ single and never previously married

__ widowed; indicate the full name of the spouse, as well as the date and place of death

____________________________________________________________

__ divorced; indicate the full name of the ex-spouse, as well as the details of the final divorce decree

____________________________________________________________


8. that I intend on marrying the following person:

Last name(s): __________________________________

Given name(s): __________________________________

Date of birth: __________________________________

Place of birth (city and country): __________________________________

Father’s last name(s): __________________________________

Father’s given name(s): __________________________________

__ living __ deceased

Mother’s last name(s) at birth (maiden): __________________________________

Mother’s given name(s): __________________________________

__ living __ deceased


9. that this person’s current residential address is:

_____________________________________________________________________

_____________________________________________________________________


10. that my telephone and/or cell phone number, as well as e-mail address, are:

Home: __________________________________

Cell phone: __________________________________

E-mail: _______________________@__________________________


11. that the person I intend on marrying (per item 8 above) and I are not related either by blood or marriage (article 87 Codice Civile)


12. that neither I nor the person I intend on marrying (per item 8 above) have ever been convicted for the attempted or successful murder of the other person’s former spouse(s) (article 88 Codice Civile)

Attached to this affidavit are true certified copies of

  • the page with photo and signature of my valid Canadian passport as well as
  • both sides of my long-form Canadian birth certificate or Certificate of Canadian Citizenship

and, if applicable

  • all pages of the final divorce decree
  • the death certificate of spouse


__________________________
(signature of the affiant)

SWORN, DECLARED and SIGNED before me at _____________________________ this ______ day of ____________, 20__.


________________________________
(signature and seal of a notary public or consular officer)

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Date Modified:
2014-02-27