申请离婚登记声明书
DECLARATION FOR DIVORCE REGISTRATION APPLICATION

出处：http://www.nnmz.gov.cn/88/2009_9_7/88_641_1252306916453_(1).html

我们双方申请离婚登记，谨此声明：
Solemnly declare, that
  

男方姓名：                                   国籍：                      
Name(Male):                                  Nationality:　　　　

出生日期：        年    月    日    民族：           职业：                   
Date of Birth:        Y    M   D                        Occupation:

文化程度：                   身份证件号：                                 
Educational Level:           Passport Number:

常住户口所在地：                                                          
Registered Permanent Residence:
 

女方姓名：                                      国籍：                      
Name(Female):                               Nationality:

出生日期：        年    月    日  民族：            职业：                   
Date of Birth:     Y    M   D                      Occupation:

文化程度：                   身份证件号：                                 
Educational Level:           Passport Number:

常住户口所在地：                                                          
Registered Permanent Residence:
  

　　我们于       年     月   日登记结婚，结婚字号               ，离婚原因是                      。我们双方自愿离婚，对于子女抚养、财产、债务等事项已达成一致处理意见并共同签署了离婚协议书。
We married on       , the certificate of marriage registration number is    .
Now we apply for divorce due to        . We apply for divorce at our free will and signed divorced agreement under unanimous disposal of take care of our children, assets and liabilities.
   

　　上述声明完全真实，如有虚假，愿承担法律责任。
　　I swear that the above is true and reliable, and I promise to undertake all corresponding legal responsibilities if there’s any falsehood.

声明人：                                                 年      月      日
                                                                 年      月      日

监誓人：                                                 年      月      日

(注：声明人签名须在监誓人面前完成) （Notice: the signature should be executed before supervisor.）