37. The application for the statement provided for in section 76 of the Act shall contain the following documents and information:(1) the name and address of the member and his spouse;
(2) in the case of married spouses, proof of the date of their marriage and either proof of the date on which proceedings were instituted or, where the application is made on the occasion of mediation, a joint declaration of the date on which the spouses ceased to live together;
(3) in the case of spouses in a civil union:(a) proof of the date of their civil union;
(b) one of the following documents, as applicable:i. proof of the date on which proceedings were instituted;
ii. where the application is made on the occasion of mediation, a joint declaration of the date on which the spouses ceased to live together;
iii. where the application is made during a joint procedure before a notary for the dissolution of a civil union, a joint declaration of the date set for determining the net value of family patrimony;
(4) in the case of spouses who were neither married nor in a civil union, an attestation from the member as to his spousal status as well as an attestation from the member and his spouse of the dates on which their conjugal relationship began and ended and, if they lived in a conjugal relationship for at least one year but less than 3 years, proof of one or the other of the cases referred to in subparagraph 2 of the first paragraph of section 71 of the Act.
The application made on the occasion of mediation shall also contain the written confirmation of an accredited mediator to the effect that he received a mandate within the context of family mediation. The application made on the occasion of a joint procedure before a notary for the dissolution of a civil union must also include written confirmation from a notary to the effect that he received a mandate as part of that procedure.