Declaration of no marriage of convenience

I,
Spouse / partner 1

Family name

First name(s)

Date of birth

dd/mm/yyyy

Nationality

Identity document number

E-mail address *

have submitted a

marriage certificate

deed of registered partnership

for registration in the Municipal Personal
Records Database (BRP) for a

marriage

partnership

contracted outside the Netherlands,
which shows that on

dd/mm/yyyy

in

I entered into a

marriage with:

partnership with:

Spouse / partner 2

Family name

First name(s)

Date of birth

dd/mm/yyyy

Nationality

Identity document number

Because at least one of us does not possess citizenship of the Netherlands and has no right to residence under Article 8 b, d or e of the Aliens Act (Vw 2000), we declare that the

marriage

partnership

was not contracted with the objective of acquiring the right to residence in the Netherlands.

We declare that we have completed this form truthfully and without reservation.

Place

Date

dd/mm/yyyy

Signature of spouse / partner 1:

Please note: first print out the form. Only then do the signatures.

Signature of spouse / partner 2:

Name

The municipality handles your personal data with care. Read more about this at www.nieuwegein.nl/privacystatement. By submitting this form you agree that we store your data.

I agree *

* = Input is required

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