The affidavit

of single status is

also

known

as

the

Certificate

of

Freedom

to

Marry, Certificate de Coutume, Certificate of No Impediment, Certificate of Nulla Osta,

Single Status Statutory Declaration, Certificate of Legal Capacity to Contract Marriage,
Single Status Certificate, Affidavit of Free Status. This document is required by almost all
countries before

a marriage

license is

issued

to

foreigners

intending

to contract

marriage. Sample form:

EMBASSY OF THE REPUBLIC OF THE PHILIPPINES)

RIYADH, SAUDI ARABIA

) S.S.

x--------------------------------------------------------x

AFFIDAVIT OF SINGLE STATUS

I, MARIA C. DELA CRUZ, of legal age, Filipino, with Philippine address at 123 Mangga
Street, General Santos City, after having been duly sworn to in accordance with law, do
hereby

depose

and

say:

1. THAT I have never contracted any marriage in the Philippines or elsewhere and I
remain SINGLE to this very day and hour;
2. THAT there is no legal impediment for me to contract marriage under the Philippine Laws;
3. THAT

am

executing

this

Affidavit

for

the

purpose

of

complying

with

therequirements relating to my forthcoming marriage to PEDRO B. RUIZ in Riyadh;

4. THAT I declare that the statements made in this affidavit are true and correct and I am
willing to bear all the legal responsibilities arising therefrom.
IN WITNESS WHEREOF, I have hereunto set my hand this 1st day of August 2013
at the Philippine Embassy, Riyadh, Saudi Arabia.

MARIA C. DELA CRUZ

Affiant

SUBCRIBED AND SWORN TO before me this 1st day of August 2013 at the
Philippine Embassy, Riyadh, Saudi Arabia, affiant exhibiting her Philippine Passport No.
123456789 issued on June 7, 2010 in Manila, Philippines.
Doc. No. _____
Service No. _____
Series
Fee
O.R. No.: ______

of:

______

Paid:

______