Affidavit of Single Status
I NOGUEIRA RAFAEL MOREIRA GOMEZ residing at CARRERA DE CASSANOVA 113, APT. 3-1 BARCELONA, 08036 personally appeared before the undersigned notary public, and under oath or affirmation make the following statements: I was born on 07/14/1992 at RIO DE JANEIRO, BRAZIL. I am a citizen of Brazil My passport number is YD033745. I am currently single, have never been married (or was divorced/widowed on NEVER and have never been remarried since).
State of ___________________
County of __________________
Sworn to (or affirmed) and subscribed before me this 17 day of January 2023 by NOGUEIRA RAFAEL MOREIRA GOMEZ who proved to me on the basis of satisfactory evidence to be the individual who ___appeared before me OR _X_online notarization. ___ Personally Known or _X_ Produced Identification Type of Identification ___Passport______
WITNESS my hand and official seal.
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Document Name: afidavit
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