Fillable POLICE RECORD CHECK DECLARATION (For use by APPLICANTS

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POLICE RECORD CHECK DECLARATION (For use by APPLICANTS

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Country of origin: CANADA
File type: PDF

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POLICE RECORD CHECK DECLARATION
(For use by APPLICANTS for
whom the Board is
collecting an electronic Police Record Check)
Name
Date of Birth
yyyy
mm dd
Position
I DECLARE, that my electronic Police Record Check provided to this Board, is a true copy of my original
Police Record Check dated ________________, and that it has not been forged, altered, amended
and/or tampered with in any manner or capacity. I make this solemn declaration conscientiously believing
it to be true, and knowing that it is of the same force and effect as if made under oath.
DATED at this day of , 20__
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POLICE RECORD CHECK DECLARATION (For use by APPLICANTS

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Completed 1 December 2021

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