Affidavit of Marriage
We, the undersigned, declare that we are legally married to each other and if requested,
would be able to provide proof of our marriage.
We certify under penalty of perjury under the laws of the State of Oregon that the
foregoing is true and accurate to the best of our knowledge, and we understand
that the University may initiate disciplinary action and impose sanctions against
any student who furnished false or misleading information to the University or its
representative. OAR 576-015-0020(6).
Student or Employee: Spouse:
Printed Name Printed Name
**NOTE**: This affidavit is for use in providing services and benefits within the purview
of Western Oregon University Housing and is not related to employee health benefits.