Statutory Declaration Form

CANADA

PROVINCE OF ONTARIO

IN THE MATTER OF [REASON FOR STATUTORY DECLARATION]

I, [NAME] of [ADDRESS OF DECLARANT],

SOLEMNLY DECLARE THAT:

 1.       Set out the relevant facts.  Each fact should be in a new paragraph and numbered consecutively.  Exhibits may be attached to the statutory declaration.  If attaching an exhibit mark it in the following way: In the body of the statutory declaration write the following ‘attached hereto and marked as Exhibit “A” is a true copy of [describe document]’ Subsequent exhibits should be labeled “B”, “C” and so forth.

AND 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.

DECLARED before me at the ____ of ______in the Province of Ontario this ______________.___________________________

A Commissioner for Taking Oaths

________________________[NAME OF DECLARANT]