Fillable Printable Statutory Declaration - Western Australia
Fillable Printable Statutory Declaration - Western Australia
Statutory Declaration - Western Australia
WESTERN
AUSTRALIA
WESTERN AUSTRALIA
O
O
A
A
T
T
H
H
S
S
,
,
A
A
F
F
F
F
I
I
D
D
A
A
V
V
I
I
T
T
S
S
A
A
N
N
D
D
S
S
T
T
A
A
T
T
U
U
T
T
O
O
R
R
Y
Y
D
D
E
E
C
C
L
L
A
A
R
R
A
A
T
T
I
I
O
O
N
N
S
S
A
A
C
C
T
T
2
2
0
0
0
0
5
5
S
S
T
T
A
A
T
T
U
U
T
T
O
O
R
R
Y
Y
D
D
E
E
C
C
L
L
A
A
R
R
A
A
T
T
I
I
O
O
N
N
I, .........................................................................................................................................
............................................................................................................................................
{name, address and occupation of person making declaration}
sincerely declare as follows:-
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
{insert content of the statutory declaration; use numbered paragraphs if content is long}
This declaration is true and I know that it is an offence to make a declaration knowing that
it is false in a material particular.
This declaration is made under the Oaths, Affidavits and Statutory Declarations Act 2005
at .....................................................................
{place}
........................................................................
{date}
in the presence of -
........................................................................
{Signature of authorised witness}
........................................................................
........................................................................
{Name of authorised witness and qualification as such a
witness}
by...............................................
{Signature of person making the
declaration}
*Important This Declaration must be made before any of the following persons:-
Academic (post-secondary institution), Accountant, Architect, Australian Consular Officer,
Australian Diplomatic Officer, Bailiff, Bank Manager, Chartered secretary, Chemist,
Chiropractor, Company auditor or liquidator, Court officer (Judge, magistrate, registrar or
clerk), Defence Force officer (Commissioned, Warrant or NCO with 5 years continuous
service), Dentist, Doctor, Electorate Officer (State), Engineer, Industrial organisation
secretary, Insurance broker, Justice of the Peace, Lawyer, Local government CEO or deputy
CEO, Local government councillor, Loss adjuster, Marriage Celebrant, Member of
Parliament (State or Commonwealth), Minister of religion, Nurse, Optometrist, Patent
Attorney, Physiotherapist, Podiatrist, Police officer, Post Officer manager, Psychologist,
Public Notary, Public Servant (State or Commonwealth), Real Estate agent, Settlement
agent, Sheriff or deputy Sheriff, Surveyor, Teacher, Tribunal officer, Veterinary surgeon
Or,
Any person before whom, under the Statutory Declarations Act 1959 of the
Commonwealth, a Statutory Declaration may be made.
IMPORTANT INFORMATION:
AS OF 1 JANUARY 2006 THERE IS NO PROVISION FOR COMMISSIONERS FOR DECLARATIONS
IN THE STATE OF WESTERN AUSTRALIA
