单身声明书一般由您本人来亲自起草,以下为单身声明书样本(用于婚姻目的)
Affidavit of Single Status
单 身 声 明 书
I (本人), English Name(英文名)_____________,Chinese Name(中文名)______________
Passport Number is (护照号码) _____, Gender(性别): ____, Citizenship of (国籍) ____
Born on(生日) DD____MM_____YY_____ at (出生地)_______________________________
Currently Residing at (居住地): ___________________________________________________
Working at (工作单位)___________ located at(位于) _______City(市) ____ State (州)
Being duly sworn in, hereby solemnly declare that (特此声明,)
[ ] I am currently single, have never been married, and have no direct affinity, and have no collateral affinity within three generation with the following Chinese citizen: (我目前单身,从未结婚,与以下结婚对象无直系血亲和三代以内旁系血亲关系)
Full Name(名字): ________________________ Gender(性别): ___________________
Date of Birth(出生日期): __________________ Place of Birth(出生地): ______________
Passport Number(护照号码) ________________
Permanent Address (长期居住地)________________________
I declare, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct. I am the person named above, and I assume full responsibility for the declaration. (我保证以上内容属实,如有不实之处,本人愿承担由此所引起的一切法律责任)
Signature of Affiant(签名): _______________ Date(日期): ____________
Full Name in Print (名字): ________________Date(日期): ____________