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G?i lc 23:34' 23/10/2011
M?u t? khai c?p gi?y xc nh?n tnh tr?ng hn nhn

C?NG HO X H?I CH? NGH?A VI?T NAM

??c l?p - T? do - H?nh phc

T? KHAI C?P GI?Y XC NH?N TNH TR?NG HN NHN

 Knh g?i: U? ban nhn dn.

H? v tn ng??i khai:

Dn t?c:.Qu?c t?ch:..

N?i th??ng tr/t?m tr.

Quan h? v?i ng??i ???c c?p Gi?y xc nh?n tnh tr?ng hn nhn:

?? ngh? ???c c?p Gi?y xc nh?n tnh tr?ng hn nhn cho ng??i c tn d??i ?y:

H? v tn:Gi?i tnh:..

Ngy, thng, n?m sinh:

Dn t?c:.Qu?c t?ch:.

S? Gi?y CMND/H? chi?u:.

N?i th??ng tr/t?m tr

.

Tnh tr?ng hn nhn hi?n t?i (1):.

.

      Ti cam ?oan l?i khai trn ?y l ?ng s? th?t v ch?u trch nhi?m tr??c php lu?t v? l?i khai c?a mnh.

      ?? ngh? U? ban nhn dn c?p Gi?y xc nh?n tnh tr?ng hn nhn cho (2)..

?? (3)..

 

                                                                              ngythngn?m

                                                                                                          Ng??i khai

                                                                                                       

 Ch thch:

(1)Ghi r: ?ang c v? ho?c c ch?ng; ho?c ch?a ??ng k k?t hn l?n no; ho?c ? ??ng k k?t hn, nh?ng ? ly hn hay ng??i kia ? ch?t;

(2) Cho b?n thn hay cho ng??i khc; n?u ?? ngh? cho ng??i khc th ph?i ghi r;

            (3) Ghi r m?c ?ch s? d?ng Gi?y xc nh?n tnh tr?ng hn nhn.

Tác giả: Nguy?n Long Ninh
Nguồn tin: www.dulichxanh.com.vn

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