1Form of declaration Empowered by s 9
I, AB, of [place of abode and occupation], solemnly and sincerely declare that [insert facts].
And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957.
AB
Declared at [place, date]
JS, Justice of the Peace
[or other person authorised to take a statutory declaration]

