STATUTORY DECLARATION — Starter Template
Provided free by Thistlegate Notary Office. This is a starting point, not legal advice.
Bring this declaration UNSIGNED to your appointment — it must be declared before the notary.

STATUTORY DECLARATION

I, ________________________________________ [full legal name], of
________________________________________ [address], solemnly and sincerely declare that:

1. ________________________________________________________________________
   ________________________________________________________________________

2. ________________________________________________________________________
   ________________________________________________________________________

3. ________________________________________________________________________
   ________________________________________________________________________

Purpose of this declaration: ______________________________________________
________________________________________________________________________

And I make this solemn declaration conscientiously believing it to be true,
and knowing that it has the same force and effect as if made under oath.

________________________________________
Declarant signature (sign before the notary)   Date: ____________________

Printed name: ____________________________
Phone: ____________________  Email: ____________________

--- FOR THE NOTARY (do not complete in advance) ---
Declared before me at ____________________ on ____________________ [date]
by ____________________ [declarant], who proved identity by ____________________.

________________________________________
Notary Public — Signature & Seal
Commission expires: ____________________