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AUSTRALIA
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STATUTORY
DECLARATION
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(1) Here insert name, address
and occupation of person making the
declaration.
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I,(1)
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(2) Here insert matter declared
to. Where the matter is long, add the words "as
follows:" and then set the matter out in numbered
paragraphs.
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do solemnly and sincerely
declare(2)
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I make this solemn declaration
by virtue of the Statutory Declarations Act
1959 as amended and subject to the penalties
provided by that Act for the making of false
statements in statutory declarations,
conscientiously believing the statements contained
in this declaration to be true in every
particular.
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(3) Signature of person making
the declaration.
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(3)
..............................................................
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Declared at
..............................................................
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on
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.........................................,
200...
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before me,
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(4)
..............................................................
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(5)
..............................................................
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(4) Signature of
person before whom the declaration is made.
(5) Here insert title of person before
whom the declaration is made.
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NOTE 1.-A
person who willfully makes a false statement in a
statutory declaration under the Statutory
Declarations Act 1959 as amended is guilty of
an offence against that Act, the punishment for
which is a fine not exceeding $200 or imprisonment
for a term not exceeding six months or both if the
offence is prosecuted summarily, or imprisonment
for a term not exceeding four years if the offence
is prosecuted upon indictment.
NOTE 2.-A statutory
declaration under the Statutory Declarations Act
1959 as amended may be made only before a
Chief, Police, Resident or Special Magistrate;
Stipendiary Magistrate or any Magistrate in respect
of whose office an annual salary is payable; a
Justice of the Peace; a person authorised under any
law in force in Australia or its Territories to
take affidavits; a person appointed under the
Statutory Declarations Act 1959 as amended
or under a State Act to be a Commissioner for
Declarations; a person appointed as a Commissioner
for Declarations under the Statutory
Declarations Act 1911, or under that Act as
amended, and holding office immediately before the
commencement of the Statutory Declarations Act
1959; a Notary Public; a person before whom a
statutory declaration may be made under the law of
the State in which a declaration is made; or a
person appointed to hold, or act in, the office in
a country or place outside Australia of Australian
Consul-General, Consul, Vice-Consul, Trade
Commissioner, Consular Agent, Ambassador, High
Commissioner, Minister, Head of Mission,
Commisioner, Charge d'Affaires, or Counsellor,
Secretary or Attache at an Embassy, High
Commissioner's office, Legation or other
post.
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