| 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] |


