APPLICATION TO USE MARRIAGE AFFIDAVIT

APPLICANT NAME:
APPLICANT DATE OF BIRTH:

REASON FOR SUBMITTING A MARRIAGE AFFIDAVIT:

OTHER INFORMATION IN SUPPORT OF APPLICATION TO USE A MARRIAGE AFFIDAVIT

Please note that not being in possession of a marriage certificate is not acceptable grounds for use of
this affidavit. If you are not submitting a copy of your marriage certificate with your application, you
will be required to provide evidence that you were unable to obtain a copy of it from the relevant
authorities.

Page 1 of 3

Marriage Affidavit
I _______________________ of _______________________________________
(Full name of applicant)
(Current address in full)
was born on the ____ day of __________ 19___ at __________________________
(Name of town/district)
In the country of _________________
(Country of Birth)
I further say that my Father is __________________________________________
(Full name of Father)
Born on the _____ day of _____________ 19____ at ________________________
(Name of town/district)
In the country of _________________
(Country of Birth)
And that my Mother is _________________________________________________
(Mothers full maiden name)
Born on the _____ day of _____________ 19____ at ________________________
(Name of town/district)
In the country of _________________
(Country of Birth)

HEREBY AFFIRM, DECLARE AND SWEAR THAT I MARRIED

________________________ who was born on the ____ day of ___________19___
(Spouses (maiden) name in full)
at_____________________ in the country of _________________
(Name of town/district)
(Country of Birth)
on the ____ day of ___________ 19___ at _________________ in _______________
(Date of Marriage)
(Name of town/district) (Name of Country)

I further say that my spouses Father is _____________________________________

(Full name of spouses Father)
Born on the _____ day of _____________ 19____ at ________________________
(Name of town/district)
In the country of _________________
(Country of Birth)

Page 2 of 3

And that my spouses Mother is __________________________________________

(Mother of spouses full maiden name)
Born on the _____ day of _____________ 19____ at ________________________
(Name of town/district)
In the country of _________________
(Country of Birth)
I further say that at the time of my marriage I was _________________________
(civil marital status immediately prior to marriage
e.g. single, divorced, widow(er) etc)
and that my spouse was a _________________________
(civil marital status immediately prior to marriage e.g. single, divorced etc)

I HEREBY AFFIRM, DECLARE AND SWEAR THAT I BELIEVE THE ABOVE DETAILS TO BE
TRUE

Signature of applicant:____________________
Signature of Solicitor/Commissioner for Oaths:______________________
Date:_______________

Page 3 of 3