Statutory Declaration

OATHS ACT 1900, NSW, NINTH SCHEDULE

I, ................................................................, of ……………………………….……………………….

[name of declarant] [residence]

do hereby solemnly declare and affirm that ............................................................................

.......................................................................................................................................................

[the facts to be stated according to the declarant’ s knowle dge, belief, or information, severally]

And I make this solemn declaration, as to the matter (or matters) aforesaid, according

to the law in this behalf made – and subject to the punishment by law provided for any

wilfully false statement in any such declaration.

Declared at: .................................................... on ........................................................................

[place] [date]

.......................................................................

[signature of declarant]

in the presence of an authorised witness, who states:

I, ......................................................................, a .......................................................................,

[name of authorised witness] [qualification of authorised witness]

certify the following matters concerning the making of this statutory declaration by the person

who made it:

[* please cross out any text that does not apply]

1. *I saw the face of the person OR *I did not see the face of the person because the person

was wearing a face covering, but I am satisfied that the person had a special justification

for not removing the covering, and

2. *I have known the person for at least 12 months OR *I have confirmed the person ’s identity using a n

identification document and the document I relied on was ……… …...………………………………….

[describe identification document relied on]

................................................................. .....................................................................

[signature of authorised witness] [date]

Fillable Printable Statutory Declaration

Fillable Printable Statutory Declaration

Statutory Declaration