Solemn Declaration

Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

SOLEMN DECLARATION

I, {{declarant_full_name}} of {{declarant_address}}, do solemnly and sincerely declare that:

Declaration of Facts

1. I am {{declarant_age}} years of age and a citizen of {{declarant_nationality}}.

2. The information provided herein is true and correct to the best of my knowledge and belief.

3. I make this solemn declaration conscientiously believing the same to be true and in accordance with the provisions of the Oaths and Affirmations Act (or similar applicable legislation in {{country}}).

Purpose of Declaration

This declaration is made for the purpose of {{purpose_of_declaration}}, to support {{supporting_document_or_claim}}.

Specific Statements (Optional)

Details relevant to the declaration:

- {{statement_1}}

- {{statement_2}}

- {{statement_3}}

Acknowledgement

I understand that making a false declaration is a serious offence and may result in legal penalties.

Sworn/Declared Before

DECLARED at {{place_of_declaration}}

This {{day_of_declaration}} day of {{month_of_declaration}}, {{year_of_declaration}}.

Signature Block

_____________________________

Signature of Declarant

Name: {{declarant_full_name}}

_____________________________

Signature of Commissioner for Oaths/Notary Public

Name: {{commissioner_name}}

Title: {{commissioner_title}}

Stamp/Seal: