Statutory Declaration Form - Western Australia Department Of Justice
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1
2Western Australia
Oaths, Affidavits and Statutory Declarations Act 2005
Statutory Declaration
{name of person
I,
making declaration}
{address of person
of
making declaration}
{occupation of person
occupation
making declaration}
sincerely declare as follows:
{insert above the 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}
On
{date}
By
{Signature of person making the declaration}
In the presence of
{Signature of authorised witness}
{Name of authorised witness}
{Qualification as such a witness}
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