Statutory Declaration
OATHS ACT 1900, NSW, EIGHTH SCHEDULE
I, ................................................................................... , do solemnly and sincerely declare that
[name of declarant]
1. The information I have provided in this form, including what is in section E (i) and (ii), is true and
correct. [Delete if this is not so].
2. [Insert here any information or other evidence you rely on]
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
and I make this solemn declaration conscientiously believing the same to be true, and by virtue of the
provisions of the Oaths Act 1900.
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 an
identification document and the document I relied on was …………...………………………………….
[describe identification document relied on]
................................................................ ...................................................................
[signature of authorised witness] [date]