Affidavit for Marriage

Please print and complete this form.

I, the undersigned, make oath and declare the following information regarding my marriage to
be held in the city/commune/village of …………………

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 current residential address is:

_____________________________________________________________________

_____________________________________________________________________

4. 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 

____________________________________________________________________


5. that I intend to marry the following person:

Last name(s): ________________________________________________________

Given name(s): _______________________________________________________

Date of birth: _________________________________________________________

Place of birth (city and country): __________________________________________

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

___________________________________________________________________

7. that the person I intend on marrying (per item 5 above) and I are not related either by blood or marriage.


__________________________
(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)