PHILIPPINE EMBASSY }

Consular Section
}
Tel Aviv, Israel
}

S.S.

AFFIDAVIT OF SINGLENESS
I, _____________________________________________________, Filipino, of legal age,
presently residing at __________________________________________________________________
after having been duly sworn to in accordance with law depose and say:
1. That I am SINGLE;
2. That under Philippine Laws, I have no legal impediment to contract marriage;
3. That I am aware that bigamy and perjury are punishable under the laws of the
Republic of the Philippines;
4. That I am executing this affidavit for the purpose of getting married.
IN WITNESS WHEREOF, I have hereunto affixed my hand this ____ day of
_________________, 20___ in Tel Aviv, Israel.
___________________________
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 20____

in Tel Aviv, Israel, affiant exhibiting to me his/her Philippine Passport No. _______________ issued on
______________________ at ________________________________.

___________________________
Consular Officer
Doc. No.

: ______________

Service No.

: ______________

Series of

: ______________

Fee

: ______________

O.R.

: ______________