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Statutory Declaration or Affidavit

I, (name, address and occupation of person making the declaration) make the following
declaration:

(Provide any required information you are unable to supply through official documents such
as, for example, a description of the tasks associated with a particular period of
employment).

I further declare that I was unable to obtain (document name) from (company name) as
(reason).

To support the claims made in this declaration, I have included the following
documents:

(list and attach the required evidence to support the statutory declaration or affidavit)

For example:

 Appointment letter
 Official position description
 Evidence of paid employment

Declared at (Place) on DD/MM/YY

Before me, (Signature, full name, qualification and address of the authorised witness before
whom the declaration is made)

Please note: If obtaining a Statutory Declaration or Affidavit outside Australia, please


refer to an Australian Embassy or the legal standard of the respective country.

VETASSESS Statutory Declaration or Affidavit template 2017

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