__________________ )S. S. ____________________ ) ------------------x
AFFIDAVIT OF SINGLENESS I, __________________, of
legal age, _______________ and a resident of
___________________________, after having been duly sworn to in accordance
with law, hereby depose and say;
1. That I am the father of __________________ who was born on
________________at _______________________; 2. That my daughter _________________________ is still single as _____ has never contracted any marriage with another person up to the present; 3. That being the father of the said _______________________, I personally know the circumstances in life of my daughter _____________________ the fact that prior to her stay abroad, ___ has been staying with us under one roof. 4. That I am executing this affidavit for the truthfulness and to manifest under oath the foregoing statements. FURTHER AFFIANT SAYETH NAUGHT. IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of __________________, at __________________.
________________ Affiant SUBSCRIBED AND SWORN to before me this ____ day of ______, ______ at ___________________________.