Affidavit Of Marital Status Form
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1ACQUEST TITLE SERVICES, LLC.
AFFIDAVIT OF MARITAL STATUS
ORDER NO:_____________
DATE:__________________
THIS AFFIDAVIT IS FOR THE CONFIDENTIAL USE OF THE ACQUEST TITLE SERVICES, LLC.
AND WILL ASSIST IN DETERMINING THE MARITAL STATUS OF THE INDIVIDUAL OWNER(S)
IN THIS TRANSACTION.
STATE OF ILLINOIS
)
) SS.
COUNTY OF ________________ )
, being duly sworn, upon oath states that he/she is the owner
of the premises described in the above captioned order.
1.
Affiant states that he/she:
a) _________ has never been married.
b) _________ is currently married to _____________________________________, with
said marriage having taken place in the year _____________.
c) _________ was married to _______________________________________________,
said marriage ending by Judgment for Dissolution of Marriage (Divorce) from
_____________________________________, in ______________(year) in
_______________________________________
Case#
County
State
d) _________ was married to ___________________________________, said marriage
ending by the death of said spouse on ____________________________. (Provide a
copy of death certificate.)
2.
Affiant further states that he/she:
a) _________ has never been a party to a civil union proceeding
b) _________ is currently a party to a civil union with _____________________________
said civil union having taken place in the year _____________.
c) _________ was a party to a civil union with __________________________________,
said civil union ending by Judgment for Dissolution of Civil Union from
_____________________________________, in ______________(year) in
_______________________________________
Case#
County
State
d) _________ was a party to a civil union with _________________________________,
said civil union ending by the death of said partner on __________________________.
(Provide a copy of death certificate.)
3.
Further that affiant makes this affidavit for the purpose of inducing ACQUEST TITLE
SERVICES, LLC, to issue its title insurance policy or its binder of insurance preliminary to the
issuance of the above policy.
___________________________________________
AFFIANT
SUBSCRIBED AND SWORN TO BEFORE ME THIS_______________DAY___________________,
20______.
_______________________________________________
NOTARY PUBLIC
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