The year , this ______,day of ______, at the premises of the ConsulateGeneral of Italy situated at Harp House, 83/86 Farringdon Street – Londra EC4A 4BL, before me, duly empowered to exercise notarial duties as by consular decree n. of the
======HAS PERSONALLY APPEARED=====
[b1],
born in [b2]
on [b3]
[b4]citizen ,
Who declares to reside at : [b5]
The above appearer, whose identity I have ascertained, has requested that this statement be accepted with the assistance of the attesting witnesses below, whom he/she knows personally and who declare they are over 18 years of age, suitable and with no legal interest in this deed and who know the English language :
1) [b6]
born in [b7]
on [b8]
[b9] citizen
who declares to reside at:
[b10]
whose identity I have ascertained by means of
passport no. [b11],
issued on [b12],
and valid until [b13];
2) [b14]
born in [b15]
on [b16]
[b17] citizen
who declares to reside at:
[b18]
whose identity I have ascertained by means of
passport no. [b19],
issued on [b20],
and valid until [b21];
3) [b22]
born in [b23]
on [b24]
[b25] citizen
who declares to reside at:
[b26]
whose identity I have ascertained by means of
passport no. [b27],
issued on [b28],
and valid until [b29];
4) [b30]
born in [b31]
on [b32]
[b33] citizen
who declares to reside at:
[b34]
whose identity I have ascertained by means of
passport no. [b35],
issued on [b36],
and valid until [b37];
I the undersigned Notary Department Official, having advised the above informants of the moraland legal consequences of their duty to tell thetruth and of the criminal consequences they willincur in case of false or reticent statements, have read the following form of oath: “I am aware of the moral and legal responsibility that I herebyassume and I undertake to speak the whole truth and not to conceal anything that I am aware of”;at which point the informants pronounce the above form of oath. Thus, having asked them aboutthe reason for their being at the Consulate, by mutual consent they have hereby given the following
STATEMENT
We are aware and we know that:
[b38],
born in [b39]
on [b40]
[b41]citizen ,
Who declares to reside at : [b42]
and whose parents are[b43] and
[b44],
is SINGLE;
that the above-mentioned is unmarried and ispresently free to marry and has beenunmarried throughout his permanence abroad;
that there is no legal impediment of any kind to
his marriage under the laws of Australia.
As requested, I, have received this deed that I have read to the witnessesand to the applicant who declare they approve it and,deeming it consistent with their will, underwrite it
before me.
This document consists of two single-sided typed
pages.
Applicant ______
1stWitness ______
2ndWitness ______
3rdWitness ______[b45]
4thWitness ______
L’anno ______, il giorno ______del
mese di ______,
nella sede del Consolato Generale d’Italia, sita
in Harp House, al n.83/86Farringdon Street – Londra EC4A 4BL
Innanzi a me, delegato/a
all’esercizio delle funzioni notarili con decreto
n. del
SI E’ COSTITUITO
[b46],
Nato a [b47]
Il [b48]
Cittadino[b49],
Che dichiara di risiedere al : [b50]
Detto comparente, della cui identità personale io
Delegato sono certo, mi fa richiesta perchè
riceva l’attestazione giurata di cui a mezzo dei
testimoni sotto indicati, da lui conosciuti e
che, da me interpellati, mi dichiarano di essere
maggiorenni, idonei e non interessati a questo
atto e di conoscere la lingua inglese:
1) [b51]
Nato/a in [b52]
Il [b53]
Cittadino/a[b54]
Che dichiara di risiedere al
[b55]
Identificato/a mediante passaporto [b56],
rilasciato il [b57]
valido fino al [b58]
2) [b59]
Nato/a in [b60]
Il [b61]
Cittadino/a[b62]
Che dichiara di risiedere al
[b63]
Identificato/a mediante passaporto [b64],
rilasciato il [b65]
valido fino al [b66]
3) [b67]
Nato/a in [b68]
Il [b69]
Cittadino/a[b70]
Che dichiara di risiedere al
[b71]
Identificato/a mediante passaporto [b72],
rilasciato il [b73]
valido fino al [b74]
4) [b75]
Nato/a in [b76]
Il [b77]
Cittadino/a[b78]
Che dichiara di risiedere al
[b79]
Identificato/a mediante passaporto [b80],
rilasciato il [b81]
valido fino al [b82]
Premessa ai suddetti da me delegato, seria ammonizione sull’importanza morale e
giuridica dell’obbligo di dire la verità e sulle
conseguenze penali cui essi incorrono in caso di
dichiarazioni false e reticenti, ho letto la formula
di legge:
“Consapevole della responsabilità morale e
giuridica che assumo con la mia deposizione,
mi impegno a dire tutta la verità e a non
nascondere nulla di quanto è a mia conoscenza”;
al che gli attestanti pronunciano la sopra
indicata formula.
Indi da me interpellati sull’oggetto della loro comparizione, hanno concordemente resa la
seguente
ATTESTAZIONE
E’ notorio ed è a nostra personale conoscenza che :
[b83],
Nato a [b84]
Il [b85]
Cittadino[b86],
Figlio di [b87] e
[b88],
Che dichiara di risiedere al : [b89]
è di stato civile libero;
-che il medesimo è libero e sciolto da ogni e
qualsiasi vincolo matrimoniale come tale si è
mantenuto anche durante la sua permanenza
all’estero;
-che giusto le leggi dello Stato cui è soggetto
l’interessato, quale cittadino australiano, nulla
osta al suo matrimonio.
Ed io richiesto, ho ricevuto il
presente atto, letto ai testimoni e al richiedente,
i quali lo approvano ed insieme a me lo
sottoscrivono perché conforme a verità ed
alla loro volontà.
Esso consta di un unico foglio scritto con
mezzi informatici sull'intera prima pagina e sulla seconda fin qui.
Richiedente ______
Testimone ______
Testimone ______[b90]
Testimone ______
Testimone ______
[b1]Surname and Name of the Bride or the Groom
[b2]Place of Birth
[b3]Date of birth- NOTE WRITE ALL THE DATES WITH THE FORMAT DD/MM/YYYY. Thank you
[b4]Nationality
[b5]Residencial Address
[b6]Surname and Name of the 1st witness
[b7]Place of Birth
[b8]Date of birth
[b9]Nationality
[b10]Residencial Address
[b11]Passport n.
[b12]Date of issue
[b13]Expiring date
[b14]Surname and Name of the 2st witness
[b15]Place of Birth
[b16]Date of birth
[b17]Nationality
[b18]Residencial Address
[b19]Passport n.
[b20]Date of issue
[b21]Expiring date
[b22]Surname and Name of the 3st witness
[b23]Place of Birth
[b24]Date of birth
[b25]Nationality
[b26]Residencial Address
[b27]Passport n.
[b28]Date of issue
[b29]Expiring date
[b30]Surname and Name of the 4st witness
[b31]Place of Birth
[b32]Date of birth
[b33]Nationality
[b34]Residencial Address
[b35]Passport n.
[b36]Date of issue
[b37]Expiring date
[b38]Surname and Name of the Bride or the Groom
[b39]Place of Birth
[b40]Date of birth
[b41]Nationality
[b42]Residencial Address
[b43]Surname and name of the bride ‘s or groom’s father
[b44]Maiden Surname and name of the the bride ‘s or groom’s mother
[b45]For Australian citizens 4 Witnesses are needed. For US citizens, 2 Witnesses only are needed.
[b46]Surname and Name of the Bride or the Groom
[b47]Place of Birth
[b48]Date of birth
[b49]Nationality
[b50]Residencial Address
[b51]Surname and Name of the 1st witness
[b52]Place of Birth
[b53]Date of birth
NOTE WRITE ALL THE DATES WITH THE FORMAT DD/MM/YYYY. Thank you
[b54]Nationality
[b55]Residencial Address
[b56]Passport n.
[b57]Date of issue of passport
[b58]Expiring date of passport
[b59]Surname and Name of the 1st witness
[b60]Place of Birth
[b61]Date of birth
[b62]Nationality
[b63]Residencial Address
[b64]Passport n.
[b65]Date of issue of passport
[b66]Expiring date of passport
[b67]Surname and Name of the 1st witness
[b68]Place of Birth
[b69]Date of birth
[b70]Nationality
[b71]Residencial Address
[b72]Passport n.
[b73]Date of issue of passport
[b74]Expiring date of passport
[b75]Surname and Name of the 1st witness
[b76]Place of Birth
[b77]Date of birth
[b78]Nationality
[b79]Residencial Address
[b80]Passport n.
[b81]Date of issue of passport
[b82]Expiring date of passport
[b83]Surname and Name of the Bride or the Groom
[b84]Place of Birth
[b85]Date of birth
[b86]Nationality
[b87]Surname and name of the bride ‘s or groom’s father
[b88]Maiden Surname and name of the the bride ‘s or groom’s mother
[b89]Residencial Address
[b90]For Australian citizens 4 Witnesses are needed. For US citizens, 2 Witnesses only are needed.