THE REPUBLIC OF THE PHILIPPINES)

CITY OF ____________ ) S.S.

x--------------------------------------------------------x

AFFIDAVIT OF SINGLE STATUS

I, GLECY LINGAL GONZALES, of legal age, single, filipino, with

Philippine address at Wellington Residence Brgy. Tres Cruses Tanza Cavite,
after having been duly sworn to in accordance with law, do hereby depose and
say:

1. THAT I have never contracted any marriage in the Philippines or

elsewhere and I remain SINGLE to this very day and hour;

2. THAT there is no legal impediment for me to contract marriage under the

Philippine Laws;

3. THAT I am executing this Affidavit for the purpose of attachment on

Voter’s Certification.

4. THAT I declare that the statements made in this affidavit are true and
correct and I am willing to bear all the legal responsibilities arising
therefrom.

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of

________ 2022 at _____________.

GLECY LINGAL GONZALES

Affiant

SUBCRIBED AND SWORN TO before me this ___ day of _______

2022 at ____________, affiant exhibiting her Philippine Voter’s No. 1019-
0230B-E1390GLG20000.

Doc No. ____ Notary public

Page No. ____
Book No. ____
Series of 2022