о несостоянии в браке

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Page 1: о несостоянии в браке

UKRAINEUKRAINE UKRAINEUKRAINE

SWEDISH AUTHORITIES

AFFIDAVIT(SELF DECLARATION OF NO IMPEDIMENT TO MARRIAGE)

KNOW ALL MEN BY THESE PRESENTS that I, MARYNA P. KOROPETS, under penalty of perjury do solemnly and sincerely declare as follows:

My full name is Maryna Petrivna KOROPETSMy date of birth is 12-Mar-1974.My nationality is Ukrainian and my passport number is AP 358556, passport issued on 15-Apr-2004 by Nakhimovski District Police Dept. in Sebastopol.My full and permanent address is 52 Peremogy Ave., Apt. 46, Sebastopol, Ukraine.I was previously married to:(1) ILIA V. VARGANYK born 1973 (married on 22-Jun-1991) but was divorced on 27-Aug-1996; and (2) VALERII V. CHEBOTARIOV born 1973 (married on 9-Sep-2000) but was divorced on 9-Oct-2002.

I remain divorced to this day and I am single in Ukraine and elsewhere, as shown by my passport(see details above) with no endorsement of marriage made.I am free to marry and know of no legal impediment to my marrying.

AND I make this solemn Declaration conscientiously believing the same to be true and by virtue of the provisions of the Statutory Declarations provisions contained in Section 25 of Ukrainian Domestic Relations Code. I also understand that the Notary Public only certifies the authenticity of the signature and accepts no responsibility for the contents of the affidavit by virtue of Section 6.2 Title 7 of Ukrainian Notaries Practice Rules.

SIGNED AND DECLARED in Sebastopolon this thirty-first day of July two thousand and twelve.

by: ( signature ) Maryna P. Koropets

This Declaration was prepared with my full consent, understanding and knowledge.

In the city of Sebastopol, Ukraine

Subscribed and sworn to before me, Olena GOLOVA, Private Notary in and for Sebastopol, Ukraine, this thirty-first day of July two thousand and twelve by Maryna P. KOROPETS who proved to me on the basis of satisfactory evidence to be the person who appeared before me and acknowledged to me that she has executed this instrument in her authorized capacity.

Registered No. 1964Stamp duty paid: as agreed

PRIVATE NOTARY: (signature) O. Golova

[SEAL: Olena V. GOLOVA, Private Notary in and for Sebastopol]

S/n BPT  394159 Comb i n

WARNING: This stamp paper has a multi-level fraud protection

MINISTRY OF JUSTICEMINISTRY OF JUSTICE